[0001] A cough is a protective reflexive action that helps clear the large breathing passages
of the lungs from bodily secretions, irritants, foreign particles and microbes. A
cough occurs when special cells along the air passages get irritated and trigger a
chain of events, resulting in air being forced out of the lungs under high pressure.
The cough reflex includes three phases: an inhalation, a forced exhalation against
a closed glottis, and a violent release of air from the lungs following opening of
the glottis, usually accompanied by a distinctive sound. Coughing can happen voluntarily
as well as involuntarily.
[0002] Cough, although a common affliction, may have one or a combination of causes. For
example, cough may be a result of a simple viral upper respiratory infection, of short
duration, lasting but a few weeks (acute cough). However, cough can be persistent,
lasting for several weeks, months, or even years (chronic cough). Chronic cough may
be caused by continuous mucus drainage down the throat, asthma, gastroesophageal reflux,
a variety of pulmonary disorders including chronic bronchitis and lung tumors, pollutants,
choking, cardiovascular disorders, and even as a side effect of certain medications
such as Angiotensin-Converting Enzyme (ACE) inhibitors. In some cases, coughing serves
as a protective mechanism by preventing aspiration of foreign material into the lungs
or, as with infectious processes, expulsion of unwanted mucus and pathogens from the
airway. However, in many cases of chronic cough, the mechanism serves no useful purpose
and may dramatically affect one's entire lifestyle causing sleeplessness, exhaustion,
annoyance, self consciousness, and social limitation. Physical consequences may be
hoarseness, incontinence of urine or stool, perspiration, and chest wall pain. Therefore,
in those situations where cough serves no useful purpose, the benefit of a pharmaceutical
composition and/or therapeutic compound to suppress cough, termed antitussives, are
highly desirable.
[0003] The complications of coughing can be classified as either acute or chronic. Acute
complications include cough syncope (fainting spells due to decreased blood flow to
the brain when coughs are prolonged and forceful), insomnia, cough-induced vomiting,
rupture of blebs causing spontaneous pneumothorax (although this still remains to
be proven), subconjunctival hemorrhage or "red eye", coughing defecation and in women
with a prolapsed uterus, cough urination. Chronic complications are common and include
abdominal or pelvic hernias, fatigue fractures of lower ribs and costochondritis.
[0004] Even though cough medicines are a common an over-the-counter remedy for individuals
seeking outpatient medical attention, their effectiveness as a treatment for a cough
is doubtful. In 2006, the American College of Chest Physicians issued guidelines stating
that "most over the counter cough medications are ineffective", and several research
reports seem to confirm this conclusion. For example, the non-opiate antitussive drug
Dextromethorphan is marketed as a cough therapy. However, its efficacy and suitability
as a treatment for cough is questionable, since its apparent success as a clinical
treatment was attributed to a placebo effect; Dextromethorphan itself had no efficacy
in treating cough. (
Ramsey et al., Br. J. Clin. Pharmacol.) Similarly, the decongestant pseudoephedrine has been to shown to have very limited
efficacy in the citric acid induced cough model in guinea-pigs (
Minamizawa et. al., J Pharmacol. Sci. 102(1); 136-142, 2006) and most of the literature fails to demonstrate that pseudoephedrine has an antitussive
effect. In fact, although a number of papers describe effects of pseudoephedrine on
"cough and cold" (which has little meaning in the medical field), none describes or
even examines direct antitussive effect. Lastly, a review article reports that presumptions
about efficacy of the antihistamine diphenhydramine against cough in humans are not
univocally substantiated in literature. (
Bjornsdottir et al., Pharma. World Sci. 29(6): 577-583, 2007). In other words, there is no strong evidence that antihistamines have any efficacy
in cough.
[0005] Thus, there is a still exists a need for the development of pharmaceutical compositions
and/or therapeutic compounds having an antitussive activity.
SUMMARY
[0006] Aspects of the present specification disclose compositions comprising a plurality
of therapeutic compounds having antitusive activity. Therapeutic compounds include,
without limitation, a methylxanthine, a non-opiate antitussive agent, an opiate antitussive
agent, a decongestant, an expectorant, a mucolytic agent, an anti-histamine, a non-steroidal
anti-inflammatory drug (NSAID), a neuropathic pain agent, a terpene, an ACE inhibitor,
an angiotensin II receptor antagonist or any combination thereof. The composition
disclosed herein may reduce an unwanted side and/or reduce a symptom associated with
a coughing condition. The composition disclosed herein may suppress a vagal nerve
function associated with a cough, suppress a central nerve function associated with
a cough, and/or suppress a peripheral nerve function associated with a cough.
[0007] Aspects of the present specification also disclose compositions comprising a methylxanthine
and a plurality of additional therapeutic compounds having antitusive activity. Methylxanthines
include, without limitation, Aminophylline, Caffeine, IBMX, Paraxanthine, Pentoxifylline,
Theobromine, Theophylline, Xanthine, or any combination thereof. Additional therapeutic
compounds include, without limitation, a non-opiate antitussive agent, an opiate antitussive
agent, a decongestant, an expectorant, a mucolytic agent, an anti-histamine, a non-steroidal
anti-inflammatory drug (NSAID), a neuropathic pain agent, a terpene, an ACE inhibitor,
an angiotensin II receptor antagonist or any combination thereof. The composition
disclosed herein may reduce an unwanted side and/or reduce a symptom associated with
a coughing condition. The composition disclosed herein may suppress a vagal nerve
function associated with a cough, suppress a central nerve function associated with
a cough, and/or suppress a peripheral nerve function associated with a cough.
[0008] Aspects of the present specification also disclose methods of treating a coughing
condition in an individual. The disclosed methods comprising the step of administering
a pharmaceutical composition disclosed herein to an individual, wherein administration
reduces a symptom associated with the coughing condition. The coughing condition may
be an acute coughing condition, a subacute coughing condition, or a chronic coughing
condition. The coughing condition may be a non-productive coughing condition or a
productive coughing condition. The coughing condition may be a cough associated with
a disease or disorder. Administration of a pharmaceutical composition may also reduce
an unwanted side in the individual.
[0009] Aspects of the present specification disclose uses of the disclosed compositions
and/or therapeutic compounds in the manufacture of a medicament for the treatment
of a coughing condition.
[0010] Aspects of the present specification disclose uses of the disclosed compositions
and/or therapeutic compounds in the treatment of a coughing condition.
DESCRIPTION
[0011] The present specification discloses combinations of various therapeutic compounds
that when combined produce synergistic effects in reducing a symptom associated with
a coughing condition. Consequently, a considerably reduced dose of both therapeutic
compounds can be given for an equivalent effect for each individual therapeutic compound,
thereby reducing side-effects and drug burden.
[0012] In addition, the present specification discloses that administration of the disclosed
combinations of various therapeutic compounds by inhalation, a therapeutically effect
is observed at one-third the dose administered orally. Via the inhaled route, therapeutic
compounds disclosed herein are surprisingly potent and do not follow the oral PK/PD
relationship, revealing that the disclosed combinations of various therapeutic compounds
have a substantially local effect in the lung. Consequently, via the inhaled route,
less drug is given for an equivalent oral effect, so reducing side-effects and drug
burden.
[0013] Aspects of the present specification disclose, in part, a pharmaceutical composition.
As used herein, the term "pharmaceutical composition" is synonymous with "pharmaceutically
acceptable composition" and refers to a therapeutically effective concentration of
an active ingredient, such as, e.g., any of the therapeutic compounds disclosed herein.
As used herein, the term "pharmaceutically acceptable" refers to any molecular entity
or composition that does not produce an adverse, allergic or other untoward or unwanted
reaction when administered to an individual. A pharmaceutical composition disclosed
herein is useful for medical and veterinary applications. A pharmaceutical composition
may be administered to an individual alone, or in combination with other supplementary
active ingredients, agents, drugs or hormones.
[0014] A pharmaceutical composition disclosed herein may comprise one or more therapeutic
compounds disclosed herein. In one embodiment, pharmaceutical composition disclosed
herein may comprise only a single a therapeutic compound having antitussive activity.
In another embodiment, pharmaceutical composition disclosed herein may comprise a
plurality of therapeutic compounds having antitussive activity. In aspects of this
embodiment, a pharmaceutical composition disclosed herein comprises at least one therapeutic
compound having antitussive activity, at least two therapeutic compounds having antitussive
activity, at least three therapeutic compounds having antitussive activity, or at
least four therapeutic compounds having antitussive activity. In other aspects of
this embodiment, a pharmaceutical composition disclosed herein comprises at most two
therapeutic compounds having antitussive activity, at most three therapeutic compounds
having antitussive activity, or at most four therapeutic compounds having antitussive
activity. In yet other aspects of this embodiment, a pharmaceutical composition disclosed
herein comprises one to three therapeutic compounds having antitussive activity, two
to four therapeutic compounds having antitussive activity, two to five therapeutic
compounds having antitussive activity, three to five therapeutic compounds having
antitussive activity, or two to three therapeutic compounds having antitussive activity.
In aspects of this embodiment, a therapeutic compound having antitussive activity
includes, without limitation, a methylxanthine, a non-opiate antitussive agent, an
opiate antitussive agent, a decongestant, an expectorant, a mucolytic agent, an anti-histamine,
a non-steroidal anti-inflammatory drug (NSAID), a neuropathic pain agent, a terpene,
an ACE inhibitor, and/or an angiotensin II receptor antagonist.
[0015] In another embodiment, a pharmaceutical composition disclosed herein comprises a
methylxanthine and a single additional therapeutic compound having antitussive activity.
In another embodiment, a pharmaceutical composition disclosed herein comprises a methylxanthine
and a plurality of additional therapeutic compound having antitussive activity. In
aspects of this embodiment, a pharmaceutical composition disclosed herein comprises
a methylxanthine and at least one additional therapeutic compound having antitussive
activity at least two additional therapeutic compounds having antitussive activity,
at least three additional therapeutic compounds having antitussive activity, at least
four additional therapeutic compounds having antitussive activity. In other aspects
of this embodiment, a pharmaceutical composition disclosed herein comprises a methylxanthine
and at most one additional therapeutic compound having antitussive activity, at most
two additional therapeutic compounds having antitussive activity, at most three additional
therapeutic compounds having antitussive activity, at most four additional therapeutic
compounds having antitussive activity. In yet other aspects of this embodiment, a
pharmaceutical composition disclosed herein comprises a methylxanthine and one to
three additional therapeutic compounds having antitussive activity, two to four additional
therapeutic compound having antitussive activity, two to three additional therapeutic
compounds having antitussive activity, two to five additional therapeutic compound
having antitussive activity, or three to five additional therapeutic compound having
antitussive activity. In aspects of this embodiment, an additional therapeutic compound
having antitussive activity includes, without limitation, a non-opiate antitussive
agent, an opiate antitussive agent, a decongestant, an expectorant, a mucolytic agent,
an anti-histamine, a non-steroidal anti-inflammatory drug (NSAID), a neuropathic pain
agent, a terpene, an ACE inhibitor, and/or an angiotensin II receptor antagonist.
[0016] In another embodiment, a pharmaceutical composition disclosed herein comprises a
methylxanthine and a plurality of therapeutic compounds having antitussive activity
disclosed herein, wherein the plurality of therapeutic compounds does not include
a non-opiate antitussive agent disclosed herein. In an aspect of this embodiment,
a pharmaceutical composition disclosed herein comprises a methylxanthine and a plurality
of therapeutic compounds having antitussive activity, wherein the plurality of therapeutic
compounds does not include Dextromethorphan.
[0017] In another embodiment, a pharmaceutical composition disclosed herein comprises a
methylxanthine and a plurality of therapeutic compounds having antitussive activity
disclosed herein, wherein the plurality of therapeutic compounds does not include
an anti-histamine disclosed herein. In an aspect of this embodiment, a pharmaceutical
composition disclosed herein comprises a methylxanthine and a plurality of therapeutic
compounds having antitussive activity, wherein the plurality of therapeutic compounds
does not include Azatadine, Bromodiphenhydramine, Brompheniramine, Carbinoxamine,
Cetirizine, Chlorpheniramine, Clemestine, Dexchlorpheniramine, Dexbrompheniramine,
Diphenhydramine, Doxylamine, Pyrilamine, Tripelennamine, or Tripolidine.
[0018] A pharmaceutical composition disclosed herein may reduce an unwanted side effect
elicited by administration of one or more of the therapeutic compounds contained in
the pharmaceutical composition. Examples of unwanted side effects, include, without
limitation, sedation, cognitive fogging, dizziness, drowsiness, postural hypertension,
coordination problems, weakness, tremors, respiratory depression, psychotropic effects,
sleep disturbances, unwanted waitfulness, CNS stimulation, weight gain, appetite change,
change in sexual function, constipation, dry mouth, gut erosion, gastric ulcerations,
renal inflammation, cardiovascular hypertension, cardiovascular stimulation, hyperchlimina,
not going into public, chest pain, and/or stress incontinence.
[0019] In aspects of this embodiment, an unwanted side-effect associated with a non-opiate
antitussive agent, includes, without limitation, sedation, psychotropic effect, hallucination,
or any combination thereof. In other aspects of this embodiment, an unwanted side-effect
associated with an opiate antitussive agent includes, without limitation, sedation,
constipation, respiratory depression, or any combination thereof. In yet other aspects
of this embodiment, an unwanted side-effect associated with a decongestant includes,
without limitation, unwanted waitfulness, CNS stimulation, cardiovascular stimulation,
tachycardia, or any combination thereof. In still other aspects of this embodiment,
an unwanted side-effect associated with an antihistamine includes, without limitation,
sedation, dry mouth, a sensory-based side effect, an anti-muscarinic side effect,
or any combination thereof.
[0020] In other aspects of this embodiment, an unwanted side-effect associated with a NSAID,
includes, without limitation, gut erosion, gastric ulcerations, renal inflammation,
cardiovascular hypertension, or any combination thereof. In yet other aspects of this
embodiment, an unwanted side-effect associated with a neuropathic pain agent, includes,
without limitation, cognitive fogging, dizziness, drowsiness, coordination problems,
weakness, tremors, weight gain, appetite change, change in sexual function, sleep
disturbance, or any combination thereof. In still other aspects of this embodiment,
an unwanted side-effect associated with an ACE inhibitor, includes, without limitation,
coughing, hyperchlimina, postural hypertension, dizziness, headache, drowsiness, weakness,
or any combination thereof. In further aspects of this embodiment, an unwanted side-effect
associated with an angiotension 2 receptor antagonist, includes, without limitation,
coughing, hyperchlimina, postural hypertension, dizziness, headache, drowsiness, weakness,
or any combination thereof.
[0021] Aspects of the present specification disclose, in part, a therapeutic compound. A
therapeutic compound is a compound that provides pharmacological activity or other
direct effect in the diagnosis, cure, mitigation, treatment, or prevention of disease,
or to affect the structure or any function of the body of man or animals. Any suitable
form of a therapeutic compound may be chosen. A therapeutic compound disclosed herein
may be used in the form of a pharmaceutically acceptable salt, solvate, or solvate
of a salt, e.g. the hydrochloride. Additionally, therapeutic compound disclosed herein
may be provided as racemates, or as individual enantiomers, including the R- or S-enantiomer.
Thus, the therapeutic compound disclosed herein may comprise a R-enantiomer only,
a S-enantiomer only, or a combination of both a R-enantiomer and a S-enantiomer of
a therapeutic compound. A therapeutic compound disclosed herein may also be provided
as prodrug or active metabolite.
[0022] A therapeutic compound disclosed herein may have antitussive activity. As used herein,
the term "antitussive activity" refers to the ability of a therapeutic compound to
reduce a symptom associated with a coughing condition, including, without limitation,
the frequency of a cough, the severity of a cough, the volume or noise level of a
cough, hoarseness, sore throat, breathing difficulty, respiratory congestion, wheezing,
respiratory constriction, respiratory inflammation, muscle spasms associated with
a cough, phlegm production, fainting, insomnia, vomiting, subconjunctival hemorrhage
(red eye), cough defecation, cough urination, abdominal hernia, pelvic hernia, costochondritis,
and lower rib fractures.
[0023] In one embodiment, a therapeutic compound disclosed herein having antitussive activity
reduces a symptom associated with a coughing condition. In aspects of this embodiment,
a therapeutic compound having antitussive activity reduces a symptom associated with
a coughing condition by, e.g., at least 10%, at least 15%, at least 20%, at least
25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least
55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least
85%, at least 90% or at least 95%. In other aspects of this embodiment, a therapeutic
compound having antitussive activity reduces a symptom associated with a coughing
condition by, e.g., about 10% to about 100%, about 20% to about 100%, about 30% to
about 100%, about 40% to about 100%, about 50% to about 100%, about 60% to about 100%,
about 70% to about 100%, about 80% to about 100%, about 10% to about 90%, about 20%
to about 90%, about 30% to about 90%, about 40% to about 90%, about 50% to about 90%,
about 60% to about 90%, about 70% to about 90%, about 10% to about 80%, about 20%
to about 80%, about 30% to about 80%, about 40% to about 80%, about 50% to about 80%,
or about 60% to about 80%, about 10% to about 70%, about 20% to about 70%, about 30%
to about 70%, about 40% to about 70%, or about 50% to about 70%.
[0024] In another embodiment, a therapeutic compound disclosed herein having antitussive
activity reduces the frequency of a cough or the number of coughs that incur over
a given time period. In aspects of this embodiment, a therapeutic compound having
antitussive activity the frequency of a cough by, e.g., at least 10%, at least 15%,
at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%,
at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%,
at least 80%, at least 85%, at least 90% or at least 95%. In other aspects of this
embodiment, a therapeutic compound having antitussive activity reduces the frequency
of a cough by, e.g., about 10% to about 100%, about 20% to about 100%, about 30% to
about 100%, about 40% to about 100%, about 50% to about 100%, about 60% to about 100%,
about 70% to about 100%, about 80% to about 100%, about 10% to about 90%, about 20%
to about 90%, about 30% to about 90%, about 40% to about 90%, about 50% to about 90%,
about 60% to about 90%, about 70% to about 90%, about 10% to about 80%, about 20%
to about 80%, about 30% to about 80%, about 40% to about 80%, about 50% to about 80%,
or about 60% to about 80%, about 10% to about 70%, about 20% to about 70%, about 30%
to about 70%, about 40% to about 70%, or about 50% to about 70%.
[0025] In another embodiment, a therapeutic compound disclosed herein having antitussive
activity reduces the severity of a cough. In aspects of this embodiment, a therapeutic
compound having antitussive activity reduces the severity of a cough by, e.g., at
least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at
least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at
least 70%, at least 75%, at least 80%, at least 85%, at least 90% or at least 95%.
In other aspects of this embodiment, a therapeutic compound having antitussive activity
reduces the severity of a cough by, e.g., about 10% to about 100%, about 20% to about
100%, about 30% to about 100%, about 40% to about 100%, about 50% to about 100%, about
60% to about 100%, about 70% to about 100%, about 80% to about 100%, about 10% to
about 90%, about 20% to about 90%, about 30% to about 90%, about 40% to about 90%,
about 50% to about 90%, about 60% to about 90%, about 70% to about 90%, about 10%
to about 80%, about 20% to about 80%, about 30% to about 80%, about 40% to about 80%,
about 50% to about 80%, or about 60% to about 80%, about 10% to about 70%, about 20%
to about 70%, about 30% to about 70%, about 40% to about 70%, or about 50% to about
70%.
[0026] In another embodiment, a therapeutic compound disclosed herein having antitussive
activity reduces muscle spasms associated with a cough. In aspects of this embodiment,
a therapeutic compound having antitussive activity reduces muscle spasms associated
with a cough by, e.g., at least 10%, at least 15%, at least 20%, at least 25%, at
least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at
least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at
least 90% or at least 95%. In other aspects of this embodiment, a therapeutic compound
having antitussive activity reduces muscle spasms associated with a cough by, e.g.,
about 10% to about 100%, about 20% to about 100%, about 30% to about 100%, about 40%
to about 100%, about 50% to about 100%, about 60% to about 100%, about 70% to about
100%, about 80% to about 100%, about 10% to about 90%, about 20% to about 90%, about
30% to about 90%, about 40% to about 90%, about 50% to about 90%, about 60% to about
90%, about 70% to about 90%, about 10% to about 80%, about 20% to about 80%, about
30% to about 80%, about 40% to about 80%, about 50% to about 80%, or about 60% to
about 80%, about 10% to about 70%, about 20% to about 70%, about 30% to about 70%,
about 40% to about 70%, or about 50% to about 70%.
[0027] In another embodiment, a therapeutic compound disclosed herein having antitussive
activity reduces the volume or noise level of a cough. In aspects of this embodiment,
a therapeutic compound having antitussive activity reduces the volume or noise level
of a cough by, e.g., at least 10%, at least 15%, at least 20%, at least 25%, at least
30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least
60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least
90% or at least 95%. In other aspects of this embodiment, a therapeutic compound having
antitussive activity reduces the volume or noise level of a cough by, e.g., about
10% to about 100%, about 20% to about 100%, about 30% to about 100%, about 40% to
about 100%, about 50% to about 100%, about 60% to about 100%, about 70% to about 100%,
about 80% to about 100%, about 10% to about 90%, about 20% to about 90%, about 30%
to about 90%, about 40% to about 90%, about 50% to about 90%, about 60% to about 90%,
about 70% to about 90%, about 10% to about 80%, about 20% to about 80%, about 30%
to about 80%, about 40% to about 80%, about 50% to about 80%, or about 60% to about
80%, about 10% to about 70%, about 20% to about 70%, about 30% to about 70%, about
40% to about 70%, or about 50% to about 70%.
[0028] The coughing mechanism is a reflex arc that is initiated by stimulation of sensory
nerve fibers belonging to branches of the vagal nerve distributed throughout the respiratory
tract with greatest concentration in the upper airways. There fibers respond to chemical
and/or mechanical stimuli. After stimulation, impulses travel away along nerves (afferent
limb), to intermediate nerve terminal ganglions, where connecting nerves intersect
to further transmit impulses to the cough center in the medulla. In the brain, all
nerve impulses are integrated, and a coordinated set of nerve impulses are generated
to nerves (efferent limb) leading to the expiratory muscles that contract to produce
an effective cough. A pharmaceutical composition or a therapeutic compound disclosed
herein have an antitussive effect that may work at one or at a combination of sites
along the reflex arc.
[0029] In one embodiment, a therapeutic compound disclosed herein having antitussive activity
suppresses a vagal nerve function associated with a cough. In aspects of this embodiment,
a therapeutic compound having antitussive activity suppresses vagal nerve function
associated with a cough by, e.g., at least 10%, at least 15%, at least 20%, at least
25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least
55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least
85%, at least 90% or at least 95%. In other aspects of this embodiment, a therapeutic
compound having antitussive activity suppresses vagal nerve function associated with
a cough by, e.g., about 10% to about 100%, about 20% to about 100%, about 30% to about
100%, about 40% to about 100%, about 50% to about 100%, about 60% to about 100%, about
70% to about 100%, about 80% to about 100%, about 10% to about 90%, about 20% to about
90%, about 30% to about 90%, about 40% to about 90%, about 50% to about 90%, about
60% to about 90%, about 70% to about 90%, about 10% to about 80%, about 20% to about
80%, about 30% to about 80%, about 40% to about 80%, about 50% to about 80%, or about
60% to about 80%, about 10% to about 70%, about 20% to about 70%, about 30% to about
70%, about 40% to about 70%, or about 50% to about 70%.
[0030] In another embodiment, a therapeutic compound disclosed herein having antitussive
activity suppresses a central nerve function associated with a cough. In aspects of
this embodiment, a therapeutic compound having antitussive activity suppresses central
nerve function associated with a cough by, e.g., at least 10%, at least 15%, at least
20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least
50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least
80%, at least 85%, at least 90% or at least 95%. In other aspects of this embodiment,
a therapeutic compound having antitussive activity suppresses central nerve function
associated with a cough by, e.g., about 10% to about 100%, about 20% to about 100%,
about 30% to about 100%, about 40% to about 100%, about 50% to about 100%, about 60%
to about 100%, about 70% to about 100%, about 80% to about 100%, about 10% to about
90%, about 20% to about 90%, about 30% to about 90%, about 40% to about 90%, about
50% to about 90%, about 60% to about 90%, about 70% to about 90%, about 10% to about
80%, about 20% to about 80%, about 30% to about 80%, about 40% to about 80%, about
50% to about 80%, or about 60% to about 80%, about 10% to about 70%, about 20% to
about 70%, about 30% to about 70%, about 40% to about 70%, or about 50% to about 70%.
[0031] In another embodiment, a therapeutic compound disclosed herein having antitussive
activity suppresses a peripheral nerve function associated with a cough. In aspects
of this embodiment, a therapeutic compound having antitussive activity suppresses
peripheral nerve function associated with a cough by, e.g., at least 10%, at least
15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least
45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least
75%, at least 80%, at least 85%, at least 90% or at least 95%. In other aspects of
this embodiment, a therapeutic compound having antitussive activity suppresses peripheral
nerve function associated with a cough by, e.g., about 10% to about 100%, about 20%
to about 100%, about 30% to about 100%, about 40% to about 100%, about 50% to about
100%, about 60% to about 100%, about 70% to about 100%, about 80% to about 100%, about
10% to about 90%, about 20% to about 90%, about 30% to about 90%, about 40% to about
90%, about 50% to about 90%, about 60% to about 90%, about 70% to about 90%, about
10% to about 80%, about 20% to about 80%, about 30% to about 80%, about 40% to about
80%, about 50% to about 80%, or about 60% to about 80%, about 10% to about 70%, about
20% to about 70%, about 30% to about 70%, about 40% to about 70%, or about 50% to
about 70%.
[0032] A therapeutic compound disclosed herein may be a methylxanthine. As used herein,
the term "methylxanthine" refers to a class of therapeutic compounds composed of various
purines having two oxygen atoms attached to the six-member ring of carbon and nitrogen
atoms that act as a smooth muscle relaxant, vasodilator, and/or diuretic. Methylxanthines
act as bronchodilators by relaxing bronchial smooth muscles, thereby dilating inflamed
or otherwise constricted respiratory tract airways. Methylxanthines are 1) competitive
nonselective phosphodiesterase inhibitor which raise intracellular cAMP, activate
PKA, inhibit TNF-α, and inhibit leukotriene synthesis, thereby reducing inflammation
and innate immunity; and 2) nonselective adenosine receptor antagonist, blocking A1,
A2, and A3 receptors, thereby inhibiting the bronchoconstriction and sleepiness-inducing
effects of adenosine. Methylxanthines naturally occur in as many as sixty different
plant species including the coffee plant, cacao plant, tea plant, and the kola (or
cola) plant. Examples of suitable methylxanthines include, without limitation, Aminophylline,
Caffeine (1,3,7-trimethyl-1H-purine-2,6(3H,7H)-dione), IBMX, Paraxanthine, Pentoxifylline,
Theobromine (3,7-dihydro-3,7-dimethyl-1 H-purine-2,6-dione), Theophylline (1,3-dimethyl-7H-purine-2,6-dione)
and Xanthine (3,7-dihydro-purine-2,6-dione).
[0033] A therapeutic compound disclosed herein may be a non-opiate antitussive agent. As
used herein, the term "non-opiate antitussive agent" refers to a class of non-opioid-based
therapeutic compounds that act on the central and peripheral nervous systems to suppress
the cough reflex. A non-opiate antitussive agent is preferably an NMDA antagonist.
Examples of suitable non-opiate antitussive agents include, without limitation, Benproperine,
Benzonate, Bibenzonium, Butamirate, Cloperastine, Clofedanol, Dextromethorphan, Dibunate,
Dimemorfan, Dropropizine, Fedrilate, Indantadol, Isoaminile, Morclofone, Meprotixol,
Nepinalone, Oxolamine, Oxeladin, Piperidione, Pentoxyverine, Prenoxdiazine, and Zipeprol.
[0034] A therapeutic compound disclosed herein may be an opiate antitussive agent. As used
herein, the term "opiate antitussive agent" refers to a class of opioid-based therapeutic
compounds that act on the central and peripheral nervous systems to suppress the cough
reflex. Examples of suitable opiates include, without limitation, Alfentanil, Alphamethylfentanyl,
Buprenorphine, Carfentanyl, Codeine, Diamorphine, Dihydrocodeine, Ethyl Morphine,
Etorphine, Fentanyl, Hydrocodone, Hydromorphone, Loperamide, Morphine, Noscapine,
Oripavine, Oxymorphone, Oxycodone, Papaverine, Pentazocine, Pethidine, Propoxyphene,
Remifentanil, Sufentanil, Thebaine, Tipepidine, and Tramadol.
[0035] A therapeutic compound disclosed herein may be a decongestant. As used herein, the
term "decongestant" refers to a class of therapeutic compounds that promote the secretion,
liquefaction, or expulsion of sputum of phlegm or mucus from the respiratory tract.
Decongestants act by causing the inflamed blood vessels in the nose and sinuses to
constrict, thereby reducing inflammation and mucus formation. A decongestant is preferably
an α-adrenergic receptor agonist. Examples of suitable decongestants include, without
limitation, Ephedrine, Levmetamfetamine, Naphazoline, Oxymetazoline, Phenylephrine,
Phenylpropanolamine, Propylhexedrine, Pseudoephedrine, Synephrine, and Tetrahydrozoline.
[0036] A therapeutic compound disclosed herein may be an expectorant. As used herein, the
term "expectorant" refers to a class of therapeutic compounds that promote the secretion,
liquefaction, or expulsion of sputum of phlegm or mucus from the respiratory tract.
Expectorants work by breaking the bonds between mucoproteins that create the thickness
or viscosity of mucus in the respiratory tract, thereby increasing mucus flow and
making it easier to remove from the body through coughing. Examples of suitable expectorants
include, without limitation, Ambroxol, Ammonium Bicarbonate, Ammonium Carbonate, Bromhexine,
Calcium Iodide, Carbocysteine, Guaiacol, Guaicacol Benzoate, Guaiacol Carbonate, Guaiacol
Phosphate, Guaifenesin, Guaithylline, Hydriodic Acid, Iodinated Glycerol, Potassium
Guaiacolsulfonate, Potassium Iodide, Sodium Citrate, Sodium Iodide, Storax Terebene,
Terpin, Trifolium, Althea Root, Antimony Pentasulfide, Creosote, Ipecacuanha (Syrup
of Ipecac), Levoverbenone, Senega, and Tyloxapol.
[0037] A therapeutic compound disclosed herein may be a mucolytic agent. As used herein,
the term "mucolytic agent" refers to a class of therapeutic compounds that promote
the secretion, liquefaction, or expulsion of sputum of phlegm or mucus from the respiratory
tract. Examples of suitable mucolytic agents include, without limitation, Acetylcysteine,
Bromhexine, Carbocysteine, Domiodol, Erdostine, Letostine, Lysozyme, Mecysteine Hydrochloride,
Mesna, Sobrerol, Stepronin, Tiopronin, Tyloxapol, Ambroxol, Ammonium Chloride, Dornase
Alfa, Eprazinone, Erdosteine, Letosteine, and Neltenexine.
[0038] A therapeutic compound disclosed herein may be an anti-histamine. As used herein,
the term "antihistamine" refers to a class of therapeutic compounds that inhibits
the action of histamine via one or more histamine receptors. Typically, an anti-histamine
blocking H1 receptors is used to treat coughing, a cold, and/or an allergic reaction.
Examples of suitable antihistamines include, without limitation, Acrivastine, Alimemazine,
Astemizole, Azatadine, Bromodiphenhydramine, Brompheniramine, Carbinoxamine, Cetirizine,
Chlorpheniramine, Clemastine, Cyproheptadine, Desloratadine, Dexchlorpheniramine,
Dextrobrompheniramine, Dimenhydrinate, Diphenhydramine, Doxylamine, Fexofenadine,
Hydroxyzine, Levocetirizine, Loratadine, Meclizine, Mizolastine, Quetiapine, Pheniramine,
Promethazine, Pyrilamine, Tripelennamine, and Triprolidine.
[0039] A therapeutic compound disclosed herein may be a NSAID. As used herein, the term
"NSAID" refers to a class of therapeutic compounds with analgesic, anti-inflammatory,
and anti-pyretic properties. NSAIDs reduce inflammation by blocking cyclooxygenase.
NSAIDs may be classified based on their chemical structure or mechanism of action.
Non-limiting examples of NSAIDs include a salicylate derivative NSAID, a p-amino phenol
derivative NSAID, a propionic acid derivative NSAID, an acetic acid derivative NSAID,
an enolic acid derivative NSAID, a fenamic acid derivative NSAID, a non-selective
cyclo-oxygenase (COX) inhibitor, a selective cyclooxygenase 1 (COX 1) inhibitor, and
a selective cyclooxygenase 2 (COX 2) inhibitor. A NSAID may be a profen. Examples
of a suitable salicylate derivative NSAID include, without limitation, Acetylsalicylic
acid (asprin), Diflunisal, Hydroxylethyl Salicylate, and Salsalate. Examples of a
suitable p-amino phenol derivative NSAID include, without limitation, Paracetamol
and Phenacetin. Examples of a suitable propionic acid derivative NSAID include, without
limitation, Alminoprofen, Benoxaprofen, Dexketoprofen, Fenoprofen, Flurbiprofen, Ibuprofen,
Indoprofen, Ketoprofen, Loxoprofen, Naproxen, Oxaprozin, Pranoprofen, And Suprofen.
Examples Of A Suitable Acetic Acid Derivative NSAID Include, Without Limitation, Aceclofenac,
Acemetacin, Actarit, Alcofenac, Aloxipirin, Amfenac, Aminophenazone, Antraphenine,
Azapropazone, Benorilate, Benzydamine, Butibufen, Chlorthenoxacine, Choline Salicylate,
Clometacin, Diclofenac, Emorfazone, Epirizole, Etodolac, Feclobuzone, Felbinac, Fenbufen,
Fenclofenac, Glafenine, Indometacin, Ketorolac, Lactyl Phenetidin, Metamizole, Metiazinic
Acid, Mofebutazone, Mofezolac, Nabumetone, Nifenazone, Niflumic Acid, Oxametacin,
Pipebuzone, Propyphenazone, Proquazone, Protozininc Acid, Salicylamide, Sulindac,
Tiaramide, Tinoridine, And Zomepirac. Examples of a suitable enolic acid (Oxicam)
derivative NSAID include, without limitation, Droxicam, Isoxicam, Lornoxicam, Meloxicam,
Piroxicam, and Tenoxicam. Examples of a suitable fenamic acid derivative NSAID include,
without limitation, Flufenamic acid, Mefenamic acid, Meclofenamic acid, and Tolfenamic
acid. Examples of a suitable selective COX-2 inhibitors include, without limitation,
Celecoxib, Etoricoxib, Firocoxib, Lumiracoxib, Meloxicam, Parecoxib, Rofecoxib, and
Valdecoxib.
[0040] A therapeutic compound disclosed herein may be a neuropathic pain agent. As used
herein, the term "neuropathic pain agent" refers to a class of therapeutic compounds
with analgestic, antidepressant, anti-convulsant, anti-epileptic, and/or antispasmodic
properties. Neuropathic pain agents are typically, neurotransmitter inhibitors and/or
ion channel inhibitors. Examples of suitable neuropathic pain agents include, without
limitation, Acetazolamide, Amitriptyline, Amitriptylinoxide, Baclofen, Butriptyline,
Carbamazepine, Carisoprodol, Clobazam, Clomipramine, Conotoxins, Cyclobenzaprine,
Demexiptiline, Desipramine, Diazepam, Dibenzepin, Dimetacrine, Doxepin, Duloexetine,
Ethotoin, Felbamate, Fosphenytoin, Gabapentin, Imipramine, Imipraminoxide, Ketamine,
Lamotrigine, Lidocaine, Lignocaine, Lofepramine, Mephenytoin, Melitracen, Metapramine,
Metaxalone, Methadone, Methocarbamol, Nitroxazepine, Nortriptyline, Noxiptiline, Oxcarbazepine,
Phenobarbital, Phensuximide, Phenytoin, Pipofezine, Pregabalin, Progabide, Propizepine,
Protriptyline, Quinupramine, Stiripentol, Tiagabine, Topiramate, Trimethadione, Valproate,
Venlafaxine, Vigabatrin, and Zonisamide.
[0041] A therapeutic compound disclosed herein may be a terpene. As used herein, the term
"terpene " refers to a class of therapeutic compounds with analgestic, anti-convulsant,
and/or antispasmodic properties. Terpenes appear to function, in part, as a TripM8
calcium channel blocker involved in neurological signaling. A terpene is typically
in the form of an oil. Examples of suitable terpenes include, without limitation,
camphor oil, citronella, clove oil, eucalyptus oil, ginger oil, horsemint oil, I-menthol,
lemon oil, limonene, marjoram oil, mint oil, neroli oil, peppermint oil, pine oil,
rose oil, rosemary oil, spearmint oil, tea tree oil, thyme oil, and water mint oil.
[0042] A therapeutic compound disclosed herein may be an ACE inhibitor. ACE inhibitors reduce
the activity of the renin-angiotensin-aldosterone system and are used primarily to
treat hypertension, diabetic nephropathy, and congestive heart failure. However, one
common side-effect of ACE inhibitors is coughing. Thus, administration of a methylxanthine
in conjunction with an ACE inhibitor would be a proactive measure to reduce or prevent
the onset of a coughing side-effect produced by the ACE inhibitor. Examples of suitable
ACE inhibitors include, without limitation, Captopril, Enalapril, Lisinopril, Meleate,
and Ramipril.
[0043] A therapeutic compound disclosed herein may be an angiotensin II receptor antagonist.
Angiotensin II receptor antagonist modulate the activity of the renin-angiotensin-aldosterone
system and are used primarily to treat hypertension, diabetic nephropathy, and congestive
heart failure. However, one common side-effect of angiotensin II receptor antagonists
is coughing. Thus, administration of a methylxanthine in conjunction with an angiotensin
II receptor antagonist would be a proactive measure to reduce or prevent the onset
of a coughing side-effect produced by the angiotensin II receptor antagonist. Examples
of suitable angiotensin II receptor antagonists include, without limitation, Azilsartan,
Candesartan, Eprosartan, Irbesartan, Losartan, Olmesartan, Telmisartan, and Valsartan.
[0044] A pharmaceutical composition disclosed herein may optionally include a pharmaceutically-acceptable
carrier that facilitates processing of an active ingredient into pharmaceutically-acceptable
compositions. As used herein, the term "pharmacologically-acceptable carrier" is synonymous
with "pharmacological carrier" and means any carrier that has substantially no long
term or permanent detrimental effect when administered and encompasses terms such
as "pharmacologically acceptable vehicle, stabilizer, diluent, additive, auxiliary
or excipient." Such a carrier generally is mixed with an active compound or permitted
to dilute or enclose the active compound and can be a solid, semi-solid, or liquid
agent. It is understood that the active ingredients can be soluble or can be delivered
as a suspension in the desired carrier or diluent. Any of a variety of pharmaceutically
acceptable carriers can be used including, without limitation, aqueous media such
as, e.g., water, saline, glycine, hyaluronic acid and the like; solid carriers such
as, e.g., mannitol, lactose, starch, magnesium stearate, sodium saccharin, talcum,
cellulose, glucose, sucrose, magnesium carbonate, and the like; solvents; dispersion
media; coatings; antibacterial and antifungal agents; isotonic and absorption delaying
agents; or any other inactive ingredient. Selection of a pharmacologically acceptable
carrier can depend on the mode of administration. Except insofar as any pharmacologically
acceptable carrier is incompatible with the active ingredient, its use in pharmaceutically
acceptable compositions is contemplated. Non-limiting examples of specific uses of
such pharmaceutical carriers can be found in
Pharmaceutical Dosage Forms and Drug Delivery Systems (Howard C. Ansel et al., eds.,
Lippincott Williams & Wilkins Publishers, 7th ed. 1999);
REMINGTON: THE SCIENCE AND PRACTICE OF PHARMACY (Alfonso R. Gennaro ed., Lippincott,
Williams & Wilkins, 20th ed. 2000);
Goodman & Gilman's The Pharmacological Basis of Therapeutics (Joel G. Hardman et al.,
eds., McGraw-Hill Professional, 10th ed. 2001); and
Handbook of Pharmaceutical Excipients (Raymond C. Rowe et al., APhA Publications,
4th edition 2003). These protocols are routine procedures and any modifications are well within the
scope of one skilled in the art and from the teaching herein.
[0045] A pharmaceutical composition disclosed herein can optionally include, without limitation,
other pharmaceutically acceptable components (or pharmaceutical components), including,
without limitation, buffers, preservatives, tonicity adjusters, salts, antioxidants,
osmolality adjusting agents, physiological substances, pharmacological substances,
bulking agents, emulsifying agents, wetting agents, flavoring agents, coloring agents,
and the like. Various buffers and means for adjusting pH can be used to prepare a
pharmaceutical composition disclosed herein, provided that the resulting preparation
is pharmaceutically acceptable. Such buffers include, without limitation, acetate
buffers, citrate buffers, phosphate buffers, neutral buffered saline, phosphate buffered
saline and borate buffers. It is understood that acids or bases can be used to adjust
the pH of a composition as needed. Pharmaceutically acceptable antioxidants include,
without limitation, sodium metabisulfite, sodium thiosulfate, acetylcysteine, butylated
hydroxyanisole and butylated hydroxytoluene. Useful preservatives include, without
limitation, benzalkonium chloride, chlorobutanol, thimerosal, phenylmercuric acetate,
phenylmercuric nitrate, a stabilized oxy chloro composition and chelants, such as,
e.g., DTPA or DTPA-bisamide, calcium DTPA, and CaNaDTPA-bisamide. Tonicity adjustors
useful in a pharmaceutical composition include, without limitation, salts such as,
e.g., sodium chloride, potassium chloride, mannitol or glycerin and other pharmaceutically
acceptable tonicity adjustor. The pharmaceutical composition may be provided as a
salt and can be formed with many acids, including but not limited to, hydrochloric,
sulfuric, acetic, lactic, tartaric, malic, succinic, etc. Salts tend to be more soluble
in aqueous or other protonic solvents than are the corresponding free base forms.
It is understood that these and other substances known in the art of pharmacology
can be included in a pharmaceutical composition.
[0046] A therapeutic compound disclosed herein, or a composition comprising such a therapeutic
compound, may be formulated for either local or systemic delivery using topical, enteral
or parenteral routes of administration. Additionally, a therapeutic compound disclosed
herein may be formulated by itself in a pharmaceutical composition, or may be formulated
together with one or more other therapeutic compounds disclosed herein in a single
pharmaceutical composition.
[0047] A therapeutic compound disclosed herein, or a composition comprising such a therapeutic
compound, may be made into an inhaled formulation. Inhaled formulations suitable for
enteral or parenteral administration include, without limitation, aerosols, dry powders.
A therapeutic compound or composition disclosed herein intended for such administration
may be prepared according to any method known to the art for the manufacture of pharmaceutical
compositions.
[0048] In such inhaled dosage forms, the therapeutic compound may be prepared for delivery
as an aerosol in a liquid propellant for use in a pressurised (PDI) or other metered
dose inhaler (MDI). Propellants suitable for use in a PDI or MDI include, without
limitation, CFC-12, HFA-134a, HFA-227, HCFC-22 (difluorochloromethane), HFA-152 (difluoroethane
and isobutane). A therapeutic compound may also be delivered using a nebulisers or
other aerosol delivery system. A therapeutic compound may be prepared for delivery
as a dry powder for use in a dry powder inhaler (DPI). A dry powder for use in the
inhalers will usually have a mass median aerodynamic diameter of less than 30 pm,
preferably less than 20 pm and more preferably less than 10 pm. Microparticles having
aerodynamic diameters in the range of about 5 pm to about 0.5 pm will generally be
deposited in the respiratory bronchioles, whereas smaller particles, having aerodynamic
diameters in the range of about 2 pm to about 0.05 pm, are likely to be deposited
in the alveoli. A DPI may be a passive delivery mechanism, which relies on the individual's
inspiration to introduce the particles into the lungs, or an active delivery mechanism,
requiring a mechanism for delivering the powder to the individual. As disclosed herein,
an equivalent antitussive effect for inhaled methylxanthine requires only one-third
the dose of the same methylxanthine administered orally. In inhalatory formulations,
a therapeutically effective amount of a therapeutic compound disclosed herein for
an inhaled formulation may be between about 0.0001% (w/v) to about 60% (w/v), about
0.001% (w/v) to about 40.0% (w/v), or about 0.01% (w/v) to about 20.0% (w/v). In inhalatory
formulations, a therapeutically effective amount of a therapeutic compound disclosed
herein for an inhaled formulation may also be between about 0.0001% (w/w) to about
60% (w/w), about 0.001% (w/w) to about 40.0% (w/w), or about 0.01 % (w/w) to about
20.0% (w/w).
[0049] A therapeutic compound disclosed herein, or a composition comprising such a therapeutic
compound, may be made into a solid formulation. Solid formulations suitable for enteral
or parenteral administration include, without limitation, capsules, tablets, pills,
troches, lozenges, powders and granules suitable for inhalation or for reconstitution
into sterile injectable solutions or dispersions. A therapeutic compound or composition
disclosed herein intended for such administration may be prepared according to any
method known to the art for the manufacture of pharmaceutical compositions. In such
solid dosage forms, the therapeutic compound may be admixed with (a) at least one
inert customary excipient (or carrier), such as, e.g., sodium citrate or dicalcium
phosphate or (b) fillers or extenders, as for example, starch, lactose, sucrose, glucose,
mannitol, isomalt, and silicic acid, (c) binders, such as, e.g., carboxymethylcellulose,
alignates, gelatin, polyvinylpyrrolidone, sucrose and acacia, (d) humectants, such
as, e.g., glycerol, (e) disintegrating agents, such as, e.g., agar-agar, calcium carbonate,
corn starch, potato starch, tapioca starch, alginic acid, certain complex silicates
and sodium carbonate, (f) solution retarders, such as, e.g., paraffin, (g) absorption
accelerators, such as, e.g., quaternary ammonium compounds, (h) wetting agents, such
as, e.g., cetyl alcohol and glycerol monostearate, (i) adsorbents, such as, e.g.,
kaolin and bentonite, (j) lubricants, such as, e.g., talc, stearic acid, calcium stearate,
magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate or mixtures
thereof, and (k) buffering agents. The tablets may be uncoated or they may be coated
by known techniques to delay disintegration and absorption in the gastrointestinal
tract and thereby provide a sustained action over a longer period. For example, a
time delay material such as glyceryl monostearate or glyceryl distearate may be employed.
In solid formulations, a therapeutically effective amount of a therapeutic compound
disclosed herein typically may be between about 0.0001% (w/w) to about 60% (w/w),
about 0.001% (w/w) to about 40.0% (w/w), or about 0.01 % (w/w) to about 20.0% (w/w).
[0050] A therapeutic compound disclosed herein, or a composition comprising such a therapeutic
compound, may be made into a semi-solid formulation. Semi-solid formulations suitable
for topical administration include, without limitation, ointments, creams, salves,
and gels. A therapeutic compound or composition disclosed herein intended for such
administration may be prepared according to any method known to the art for the manufacture
of pharmaceutical compositions. In semi-solid formulations, a therapeutically effective
amount of a therapeutic compound disclosed herein typically may be between about 0.0001%
(w/v) to about 60% (w/v), about 0.001% (w/v) to about 40.0% (w/v), or about 0.01 %
(w/v) to about 20.0% (w/v). In semi-solid formulations, a therapeutically effective
amount of a therapeutic compound disclosed herein typically may also be between about
0.0001% (w/w) to about 60% (w/w), about 0.001 % (w/w) to about 40.0% (w/w), or about
0.01 % (w/w) to about 20.0% (w/w).
[0051] A therapeutic compound disclosed herein, or a composition comprising such a therapeutic
compound, may be made into a liquid formulation. Liquid formulations suitable for
enteral or parenteral administration include, without limitation, solutions, syrups,
elixirs, dispersions, emulsions, and suspensions. A therapeutic compound or composition
disclosed herein intended for such administration may be prepared according to any
method known to the art for the manufacture of pharmaceutical compositions. In such
liquid dosage forms, a therapeutic compound or composition disclosed herein may be
admixed with (a) suitable aqueous and nonaqueous carriers, (b) diluents, (c) solvents,
such as, e.g., water, ethanol, propylene glycol, polyethyleneglycol, glycerol, vegetable
oils, such as, e.g., rapeseed oil and olive oil, and injectable organic esters such
as ethyl oleate; and/or fluidity agents, such as, e.g., surfactants or coating agents
like lecithin. In the case of dispersions and suspensions, fluidity can also be controlled
by maintaining a particular particle size. In liquid formulations, a therapeutically
effective amount of a therapeutic compound disclosed herein typically may be between
about 0.0001% (w/v) to about 60% (w/v), about 0.001 % (w/v) to about 40.0% (w/v),
or about 0.01 % (w/v) to about 20.0% (w/v).
[0052] Syrups and elixirs may be formulated with sweetening agents, for example glycerol,
propylene glycol, sorbitol or sucrose. Such formulations may also contain a demulcent,
a preservative, flavoring agents, and coloring agents.
[0053] Liquid suspensions may be formulated by suspending a therapeutic compound disclosed
herein in admixture with excipients suitable for the manufacture of aqueous suspensions.
Such excipients are suspending agents, for example sodium carboxymethylcellulose,
methylcellulose, hydroxypropylmethylcellulose, sodium alginate, pectin, polyvinyl
pyrrolidone, polyvinyl alcohol, natural gum, agar, gum tragacanth and gum acacia;
dispersing or wetting agents may be a naturally occurring phosphatide, for example
lecithin, or condensation products of an alkylene oxide with fatty acids, for example
polyoxyethylene stearate, or condensation products of ethylene oxide with long-chain
aliphatic alcohols, for example heptadecaethyleneoxycetanol, or condensation products
of ethylene oxide with partial esters derived from fatty acids, for example polyoxyethylene
sorbitan monooleate.
[0054] Oily suspensions may be formulated by suspending a therapeutic compound disclosed
herein in admixture with (a) vegetable oils, such as,
e.g., almond oil, arachis oil, avocado oil, canola oil, castor oil, coconut oil, corn
oil, cottonseed oil, grape seed oil, hazelnut oil, hemp oil, linseed oil, olive oil,
palm oil, peanut oil, rapeseed oil, rice bran oil, safflower oil, sesame oil, soybean
oil, soya oil, sunflower oil, walnut oil, wheat germ oil, or a combination thereof,
(b) a saturated fatty acid, an unsaturated fatty acid, or a combination thereof, such
as,
e.g., palmitic acid, stearic acid, oleic acid, linoleic acid, linolenic acid, or a combination
thereof, (c) mineral oil such as,
e.g., liquid paraffin, (d) surfactants or detergents. The oily suspensions may contain
a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening
agents, such as those set forth above, and flavoring agents may be added to provide
a palatable oral preparation. These compositions may be preserved by the addition
of an antioxidant such as ascorbic acid.
[0055] Dispersible powders and granules suitable for preparation of an aqueous suspension
by the addition of water provide the combined therapeutic compounds in admixture with
a dispersing or wetting agent, suspending agent and one or more preservatives.
[0056] A therapeutic compound disclosed herein may be in the form of oil-in-water emulsions.
The oily phase may be a vegetable oil as disclosed herein or a mineral oil as disclosed
herein or mixtures thereof. Suitable emulsifying agents may be naturally occurring
gums, such as,
e.g., gum acacia or gum tragacanth, naturally occurring phosphatides, for example soya
bean, lecithin, and esters or partial esters derived from fatty acids and hexitol
anhydrides, for example sorbitan monooleate and condensation products of the said
partial esters with ethylene oxide, for example polyoxyethylene sorbitan monooleate.
[0057] A therapeutic compound disclosed herein, or a composition comprising such a therapeutic
compound, may also be incorporated into a drug delivery platform in order to achieve
a controlled release profile over time. Such a drug delivery platform comprises a
therapeutic compound disclosed herein dispersed within a polymer matrix, typically
a biodegradable, bioerodible, and/or bioresorbable polymer matrix. As used herein,
the term "polymer" refers to synthetic homo- or copolymers, naturally occurring homo-
or copolymers, as well as synthetic modifications or derivatives thereof having a
linear, branched or star structure. Copolymers can be arranged in any form, such as,
e.g., random, block, segmented, tapered blocks, graft, or triblock. Polymers are generally
condensation polymers. Polymers can be further modified to enhance their mechanical
or degradation properties by introducing cross-linking agents or changing the hydrophobicity
of the side residues. If crosslinked, polymers are usually less than 5% crosslinked,
usually less than 1% crosslinked.
[0058] Suitable polymers include, without limitation, alginates, aliphatic polyesters, polyalkylene
oxalates, polyamides, polyamidoesters, polyanhydrides, polycarbonates, polyesters,
polyethylene glycol, polyhydroxyaliphatic carboxylic acids, polyorthoesters, polyoxaesters,
polypeptides, polyphosphazenes, polysaccharides, and polyurethanes. The polymer usually
comprises at least about 10% (w/w), at least about 20% (w/w), at least about 30% (w/w),
at least about 40% (w/w), at least about 50% (w/w), at least about 60% (w/w), at least
about 70% (w/w), at least about 80% (w/w), or at least about 90% (w/w) of the drug
delivery platform. Examples of biodegradable, bioerodible, and/or bioresorbable polymers
and methods useful to make a drug delivery platform are described in,
e.g., Drost, et. al.,
Controlled Release Formulation, U.S. Patent 4,756,911; Smith, et. al.,
Sustained Release Drug Delivery Devices, U.S. Patent 5,378,475; Wong and Kochinke,
Formulation for Controlled Release of Drugs by Combining Hyrophilic and Hydrophobic
Agents, U.S. Patent 7,048,946; Hughes, et. al.,
Compositions and Methods for Localized Therapy of the Eye, U.S. Patent Publication 2005/0181017; Hughes,
Hypotensive Lipid-Containing Biodegradable Intraocular Implants and Related Methods, U.S. Patent Publication 2005/0244464; Altman, et al.,
Silk Fibroin Hydrogels and Uses Thereof, U.S. Patent Publication 2011/0008437; each of which is incorporated by reference in its entirety.
[0059] In aspects of this embodiment, a polymer composing the matrix is a polypeptide such
as, e.g., silk fibroin, keratin, or collagen. In other aspects of this embodiment,
a polymer composing the matrix is a polysaccharide such as,
e.g., cellulose, agarose, elastin, chitosan, chitin, or a glycosaminoglycan like chondroitin
sulfate, dermatan sulfate, keratan sulfate, or hyaluronic acid. In yet other aspects
of this embodiment, a polymer composing the matrix is a polyester such as,
e.g., D-Iactic acid, L-Iactic acid, racemic lactic acid, glycolic acid, caprolactone,
and combinations thereof.
[0060] One of ordinary skill in the art appreciates that the selection of a suitable polymer
for forming a suitable disclosed drug delivery platform depends on several factors.
The more relevant factors in the selection of the appropriate polymer(s), include,
without limitation, compatibility of polymer with drug, desired release kinetics of
drug, desired biodegradation kinetics of platform at implantation site, desired bioerodible
kinetics of platform at implantation site, desired bioresorbable kinetics of platform
at implantation site,
in vivo mechanical performance of platform, processing temperatures, biocompatibility of
platform, and patient tolerance. Other relevant factors that, to some extent, dictate
the
in vitro and
in vivo behavior of the polymer include the chemical composition, spatial distribution of
the constituents, the molecular weight of the polymer and the degree of crystallinity.
[0061] A drug delivery platform includes both a sustained release drug delivery platform
and an extended release drug delivery platform. As used herein, the term "sustained
release" refers to the release of a therapeutic compound disclosed herein over a period
of about seven days or more. As used herein, the term "extended release" refers to
the release of a therapeutic compound disclosed herein over a period of time of less
than about seven days.
[0062] In aspects of this embodiment, a sustained release drug delivery platform releases
a therapeutic compound disclosed herein with substantially zero order release kinetics
over a period of,
e.g., about 7 days after administration, about 15 days after administration, about 30
days after administration, about 45 days after administration, about 60 days after
administration, about 75 days after administration, or about 90 days after administration.
In other aspects of this embodiment, a sustained release drug delivery platform releases
a therapeutic compound disclosed herein with substantially zero order release kinetics
over a period of,
e.g., at least 7 days after administration, at least 15 days after administration, at
least 30 days after administration, at least 45 days after administration, at least
60 days after administration, at least 75 days after administration, or at least 90
days after administration.
[0063] In aspects of this embodiment, a sustained release drug delivery platform releases
a therapeutic compound disclosed herein with substantially first order release kinetics
over a period of,
e.g., about 7 days after administration, about 15 days after administration, about 30
days after administration, about 45 days after administration, about 60 days after
administration, about 75 days after administration, or about 90 days after administration.
In other aspects of this embodiment, a sustained release drug delivery platform releases
a therapeutic compound disclosed herein with substantially first order release kinetics
over a period of,
e.g., at least 7 days after administration, at least 15 days after administration, at
least 30 days after administration, at least 45 days after administration, at least
60 days after administration, at least 75 days after administration, or at least 90
days after administration.
[0064] In aspects of this embodiment, a drug delivery platform releases a therapeutic compound
disclosed herein with substantially zero order release kinetics over a period of,
e.g., about 1 day after administration, about 2 days after administration, about 3 days
after administration, about 4 days after administration, about 5 days after administration,
or about 6 days after administration. In other aspects of this embodiment, a drug
delivery platform releases a therapeutic compound disclosed herein with substantially
zero order release kinetics over a period of,
e.g., at most 1 day after administration, at most 2 days after administration, at most
3 days after administration, at most 4 days after administration, at most 5 days after
administration, or at most 6 days after administration.
[0065] In aspects of this embodiment, a drug delivery platform releases a therapeutic compound
disclosed herein with substantially first order release kinetics over a period of,
e.g., about 1 day after administration, about 2 days after administration, about 3 days
after administration, about 4 days after administration, about 5 days after administration,
or about 6 days after administration. In other aspects of this embodiment, a drug
delivery platform releases a therapeutic compound disclosed herein with substantially
first order release kinetics over a period of,
e.g., at most 1 day after administration, at most 2 days after administration, at most
3 days after administration, at most 4 days after administration, at most 5 days after
administration, or at most 6 days after administration.
[0066] Aspects of the present specification disclose, in part, a method of treating an individual
with a coughing condition. In one embodiment, the method comprises the step of administering
to an individual in need thereof a pharmaceutical composition disclosed herein, wherein
administration reduces a symptom associated with the coughing condition, thereby treating
the individual.
[0067] A coughing condition refers to a vagal nerve-based disorder where an individual has
a sudden reflex (the cough reflex), which may occur repetitively, physiologically
designed to clear the large breathing passages from any of various irritants, particles,
microbes or other organisms, secretions, etc., and which is usually accompanied by
a distinctive sound. A cough comprises an inhalation, a forced exhalation against
a closed glottis, and a release of air from the lungs which immediately follows opening
of the glottis. The cough reflex is initiated by stimulating two types of afferent
nerves, the myelinated rapidly adapting receptors and the nonmyelinated C-fibers with
endings in the lungs.
[0068] A cough can be classified by its duration, character, quality, and timing. For example,
a cough may be classified as an acute cough, a subacute cough, or a chronic cough.
An acute cough is one where there is a sudden onset of a cough and such coughing is
present in an individual for three weeks or less. A subacute cough is one where the
coughing is present in an individual for between about three weeks to about eight
weeks. A chronic cough is one where the coughing is present in an individual for about
eight weeks or more.
[0069] A cough may also be classified as a non-productive (dry) cough or a productive cough.
A non-productive cough is one where no phlegm or sputum is expelled from the respiratory
system during a cough. A productive cough is one where no phlegm or sputum is expelled
from the respiratory system during a cough. A cough may also be classified based on
occurrence such as when occurring only at night, occurring during both night and day,
or occurring during the day only.
[0070] A cough can initially be brought on by many factors, including without limitation,
asthma; bronchitis; aspiration or choking; gastroesophageal reflux disease (GERD);
infection of the respiratory tract by bacteria, viruses, or other parasites; inflammation;
some medications, such as,
e.g., ACE inhibitors; pollution; post-nasal drip; smoking; vagal nerve irritation; diseases
of the external auditory canal; lung disease, such as bronchiectasis, cystic fibrosis,
interstitial lung disease and sarcoidosis; tumors or other cancer in the lungs; habit
(habit cough); a tic or other disorders such as Tourette syndrome (tic cough); and,
cardiovascular diseases such as heart failure, pulmonary infarction and aortic aneurysm.
[0071] Where a cough is the result of an infection of the respiratory tract, some such infections
include without limitation a cold, croup, pertussis, pneumonia, and tuberculosis.
Asthma is a common cause of chronic cough. Where a cough is the only symptom of the
asthma (besides bronchial hyperresponsiveness and reversibility), the asthma is termed
cough-variant asthma. Atopic cough is a cough which occurs in individuals who have
a family history of allergic hypersensitivity (atopy) and a high number of eosinophils
in the sputum, but normal airway function. A psychogenic cough may arise without a
physical initiating factor, potentially due to emotional or psychological issues.
A post-infectious cough, as used herein, refers to a cough that persists after the
infection or other factor that initially brought on the cough has cleared. A post-infectious
cough is typically is a non-productive cough accompanied by a ticklish feeling in
the lungs, chest or throat, and can persist for weeks after removal of the initiating
factor. The actual cause of the post-infectious cough may be inflammation due to the
initiating factor, which in turn produces discomfort or the ticklish feeling, which
produces more coughing. Ironically then, the post-infectious cough itself serves as
the cause of the cough.
[0072] Aspects of the present specification disclose, in part, treating an individual suffering
from a coughing condition. As used herein, the term "treating," refers to reducing
or eliminating in an individual a clinical symptom of a coughing condition; or delaying
or preventing in an individual the onset of a clinical symptom of a coughing condition.
For example, the term "treating" can mean reducing a symptom of a condition characterized
by a coughing condition by,
e.g., at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least
45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least
75%, at least 80%, at least 85%, at least 90% at least 95%, or at least 100%. As another
example, the term "treating" can mean controlling a cough such as,
e.g., reducing the number of coughs per given time period and/or the severity of cough.
The actual symptoms associated with a coughing condition are well known and can be
determined by a person of ordinary skill in the art by taking into account factors,
including, without limitation, the location of the coughing condition, the cause of
the coughing condition, the severity of the coughing condition, and/or the tissue
or organ affected by the coughing condition. Those of skill in the art will know the
appropriate symptoms or indicators associated with a specific type of coughing condition
and will know how to determine if an individual is a candidate for treatment as disclosed
herein.
[0073] Coughing condition symptoms include, without limitation, coughing, hoarseness, sore
throat, breathing difficulty, respiratory congestion, respiratory constriction, respiratory
inflammation, phlegm production, fainting, insomnia, vomiting, subconjunctival hemorrhage
(red eye), cough defecation, cough urination, abdominal hernia, pelvic hernia, costochondritis,
and lower rib fractures. The actual symptoms associated with a coughing condition
are well known and can be determined by a person of ordinary skill in the art by taking
into account factors, including, without limitation, the location of the coughing
condition, the cause of the coughing condition, the severity of the coughing condition,
the tissue or organ affected by the coughing condition.
[0074] In one embodiment, a coughing condition comprises an acute coughing condition.
[0075] In another embodiment, a coughing condition comprises a subacute coughing condition.
[0076] In another embodiment, a coughing condition comprises a chronic coughing condition.
[0077] In another embodiment, a coughing condition comprises a non-productive coughing condition.
[0078] In another embodiment, a coughing condition comprises a productive coughing condition.
[0079] In another embodiment, a coughing condition comprises a cough associated with a disease
or disorder. In aspects of this embodiment, the disease or disorder includes an asthma,
an atopic cough a bronchitis, a gastroesophageal reflux disease (GERD), an infection
of the respiratory tract, an inflammation, a medication, a pollutant, a post-nasal
drip, a smoking event, a vagal nerve irritation, a diseases of the external auditory
canal, a lung disease, a lung tumor, a habit cough, a tic, a Tourette syndrome, a
cardiovascular disease, a post-infectious cough. In an aspect of this embodiment,
the lung disease includes, without limitation, a bronchiectasis, a cystic fibrosis,
an interstitial lung disease, a sarcoidosis, a COPD. In another aspect of this embodiment,
the cardiovascular disease includes, without limitation, a heart failure, a pulmonary
infarction and an aortic aneurysm. In yet another aspect of this embodiment, the infection
of the respiratory tract includes, without limitation, a cold, croup, pertussis, pneumonia,
and tuberculosis.
[0080] A composition or compound is administered to an individual. An individual is typically
a human being. Typically, any individual who is a candidate for a conventional coughing
condition treatment is a candidate for a coughing condition treatment disclosed herein.
Pre-operative evaluation typically includes routine history and physical examination
in addition to thorough informed consent disclosing all relevant risks and benefits
of the procedure.
[0081] A pharmaceutical composition disclosed herein may comprise a therapeutic compound
in a therapeutically effective amount. As used herein, the term "effective amount"
is synonymous with "therapeutically effective amount", "effective dose", or "therapeutically
effective dose" and when used in reference to treating a coughing condition refers
to the minimum dose of a therapeutic compound disclosed herein necessary to achieve
the desired therapeutic effect and includes a dose sufficient to reduce a symptom
associated with a coughing condition. The effectiveness of a therapeutic compound
disclosed herein in treating a coughing condition can be determined by observing an
improvement in an individual based upon one or more clinical symptoms, and/or physiological
indicators associated with the coughing condition. An improvement in a coughing condition
also can be indicated by a reduced need for a concurrent therapy.
[0082] The appropriate effective amount of a therapeutic compound disclosed herein to be
administered to an individual for a particular coughing condition can be determined
by a person of ordinary skill in the art by taking into account factors, including,
without limitation, the type of coughing condition, the location of the coughing condition,
the cause of the coughing condition, the severity of the coughing condition, the degree
of relief desired, the duration of relief desired, the particular therapeutic compound
used, the rate of excretion of the therapeutic compound used, the pharmacodynamics
of the therapeutic compound used, the nature of the other compounds to be included
in the composition, the particular route of administration, the particular characteristics,
history and risk factors of the patient, such as,
e.g., age, weight, general health and the like, or any combination thereof. Additionally,
where repeated administration of a therapeutic compound is used, an effective amount
of a therapeutic compound will further depend upon factors, including, without limitation,
the frequency of administration, the half-life of the therapeutic compound, or any
combination thereof. In is known by a person of ordinary skill in the art that an
effective amount of a therapeutic compound disclosed herein can be extrapolated from
in vitro assays and
in vivo administration studies using animal models prior to administration to humans.
[0083] Wide variations in the necessary effective amount are to be expected in view of the
differing efficiencies of the various routes of administration. For instance, oral
administration of a therapeutic compound disclosed herein generally would be expected
to require higher dosage levels than administration by inhalation. Similarly, systemic
administration of a therapeutic compound disclosed herein would be expected to require
higher dosage levels than a local administration. Variations in these dosage levels
can be adjusted using standard empirical routines of optimization, which are well-known
to a person of ordinary skill in the art. The precise therapeutically effective dosage
levels and patterns are preferably determined by the attending physician in consideration
of the above-identified factors. One skilled in the art will recognize that the condition
of the individual can be monitored throughout the course of therapy and that the effective
amount of a therapeutic compound disclosed herein that is administered can be adjusted
accordingly.
[0084] In aspects of this embodiment, a therapeutically effective amount of a therapeutic
compound disclosed herein reduces a symptom associated with a coughing condition by,
e.g., at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least
35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least
65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least
95% or at least 100%. In other aspects of this embodiment, a therapeutically effective
amount of a therapeutic compound disclosed herein reduces a symptom associated with
a coughing condition by, e.g., at most 10%, at most 15%, at most 20%, at most 25%,
at most 30%, at most 35%, at most 40%, at most 45%, at most 50%, at most 55%, at most
60%, at most 65%, at most 70%, at most 75%, at most 80%, at most 85%, at most 90%,
at most 95% or at most 100%. In yet other aspects of this embodiment, a therapeutically
effective amount of a therapeutic compound disclosed herein reduces a symptom associated
with a coughing condition by, e.g., about 10% to about 100%, about 10% to about 90%,
about 10% to about 80%, about 10% to about 70%, about 10% to about 60%, about 10%
to about 50%, about 10% to about 40%, about 20% to about 100%, about 20% to about
90%, about 20% to about 80%, about 20% to about 20%, about 20% to about 60%, about
20% to about 50%, about 20% to about 40%, about 30% to about 100%, about 30% to about
90%, about 30% to about 80%, about 30% to about 70%, about 30% to about 60%, or about
30% to about 50%.
[0085] In other aspects of this embodiment, a therapeutically effective amount of a therapeutic
compound disclosed herein generally is in the range of about 0.001 mg/kg/day to about
100 mg/kg/day. In aspects of this embodiment, an effective amount of a therapeutic
compound disclosed herein may be, e.g., at least 0.001 mg/kg/day, at least 0.01 mg/kg/day,
at least 0.1 mg/kg/day, at least 1.0 mg/kg/day, at least 5.0 mg/kg/day, at least 10
mg/kg/day, at least 15 mg/kg/day, at least 20 mg/kg/day, at least 25 mg/kg/day, at
least 30 mg/kg/day, at least 35 mg/kg/day, at least 40 mg/kg/day, at least 45 mg/kg/day,
or at least 50 mg/kg/day. In other aspects of this embodiment, an effective amount
of a therapeutic compound disclosed herein may be in the range of, e.g., about 0.001
mg/kg/day to about 10 mg/kg/day, about 0.001 mg/kg/day to about 15 mg/kg/day, about
0.001 mg/kg/day to about 20 mg/kg/day, about 0.001 mg/kg/day to about 25 mg/kg/day,
about 0.001 mg/kg/day to about 30 mg/kg/day, about 0.001 mg/kg/day to about 35 mg/kg/day,
about 0.001 mg/kg/day to about 40 mg/kg/day, about 0.001 mg/kg/day to about 45 mg/kg/day,
about 0.001 mg/kg/day to about 50 mg/kg/day, about 0.001 mg/kg/day to about 75 mg/kg/day,
or about 0.001 mg/kg/day to about 100 mg/kg/day. In yet other aspects of this embodiment,
an effective amount of a therapeutic compound disclosed herein may be in the range
of, e.g., about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to about
15 mg/kg/day, about 0.01 mg/kg/day to about 20 mg/kg/day, about 0.01 mg/kg/day to
about 25 mg/kg/day, about 0.01 mg/kg/day to about 30 mg/kg/day, about 0.01 mg/kg/day
to about 35 mg/kg/day, about 0.01 mg/kg/day to about 40 mg/kg/day, about 0.01 mg/kg/day
to about 45 mg/kg/day, about 0.01 mg/kg/day to about 50 mg/kg/day, about 0.01 mg/kg/day
to about 75 mg/kg/day, or about 0.01 mg/kg/day to about 100 mg/kg/day. In still other
aspects of this embodiment, an effective amount of a therapeutic compound disclosed
herein may be in the range of, e.g., about 0.1 mg/kg/day to about 10 mg/kg/day, about
0.1 mg/kg/day to about 15 mg/kg/day, about 0.1 mg/kg/day to about 20 mg/kg/day, about
0.1 mg/kg/day to about 25 mg/kg/day, about 0.1 mg/kg/day to about 30 mg/kg/day, about
0.1 mg/kg/day to about 35 mg/kg/day, about 0.1 mg/kg/day to about 40 mg/kg/day, about
0.1 mg/kg/day to about 45 mg/kg/day, about 0.1 mg/kg/day to about 50 mg/kg/day, about
0.1 mg/kg/day to about 75 mg/kg/day, or about 0.1 mg/kg/day to about 100 mg/kg/day.
[0086] In other aspects of this embodiment, an effective amount of a therapeutic compound
disclosed herein may be in the range of, e.g., about 1 mg/kg/day to about 10 mg/kg/day,
about 1 mg/kg/day to about 15 mg/kg/day, about 1 mg/kg/day to about 20 mg/kg/day,
about 1 mg/kg/day to about 25 mg/kg/day, about 1 mg/kg/day to about 30 mg/kg/day,
about 1 mg/kg/day to about 35 mg/kg/day, about 1 mg/kg/day to about 40 mg/kg/day,
about 1 mg/kg/day to about 45 mg/kg/day, about 1 mg/kg/day to about 50 mg/kg/day,
about 1 mg/kg/day to about 75 mg/kg/day, or about 1 mg/kg/day to about 100 mg/kg/day.
In yet other aspects of this embodiment, an effective amount of a therapeutic compound
disclosed herein may be in the range of,
e.g., about 5 mg/kg/day to about 10 mg/kg/day, about 5 mg/kg/day to about 15 mg/kg/day,
about 5 mg/kg/day to about 20 mg/kg/day, about 5 mg/kg/day to about 25 mg/kg/day,
about 5 mg/kg/day to about 30 mg/kg/day, about 5 mg/kg/day to about 35 mg/kg/day,
about 5 mg/kg/day to about 40 mg/kg/day, about 5 mg/kg/day to about 45 mg/kg/day,
about 5 mg/kg/day to about 50 mg/kg/day, about 5 mg/kg/day to about 75 mg/kg/day,
or about 5 mg/kg/day to about 100 mg/kg/day.
[0087] In other aspects of this embodiment, a therapeutically effective amount of a therapeutic
compound disclosed herein generally is in the range of about 1 mg/day to about 3,000
mg/day. In aspects of this embodiment, an effective amount of a therapeutic compound
disclosed herein may be,
e.g., at least 50 mg/day, at least 100 mg/day, at least 150 mg/day, at least 200 mg/day,
at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at least 400 mg/day,
at least 450 mg/day, at least 500 mg/day, at least 550 mg/day, at least 600 mg/day,
at least 650 mg/day, at least 700 mg/day, at least 750 mg/day, at least 800 mg/day,
at least 850 mg/day, at least 900 mg/day, at least 950 mg/day, at least 1,000 mg/day,
at least 1,50 mg/day, at least 1,100 mg/day, at least 1,150 mg/day, at least 1,200
mg/day, at least 1,250 mg/day, at least 1,300 mg/day, at least 1,350 mg/day, at least
1,400 mg/day, at least 1,450 mg/day, at least 1,500 mg/day, at least 1,600 mg/day,
at least 1,700 mg/day, at least 1,800 mg/day, at least 1,900 mg/day, at least 2,000
mg/day, at least 2,100 mg/day, at least 2,200 mg/day, at least 2,300 mg/day, at least
2,400 mg/day, at least 2,500 mg/day, at least 2,600 mg/day, at least 2,700 mg/day,
at least 2,800 mg/day, at least 2,900 mg/day, or at least 3,000 mg/day. In yet other
aspects of this embodiment, an effective amount of a therapeutic compound disclosed
herein may be between,
e.g., about 50 mg/day to about 1,000 mg/day, about 100 mg/day to about 1,000 mg/day,
about 150 mg/day to about 1,000 mg/day, about 200 mg/day to about 1,000 mg/day, about
250 mg/day to about 1,000 mg/day, about 300 mg/day to about 1,000 mg/day, about 350
mg/day to about 1,000 mg/day, about 400 mg/day to about 1,000 mg/day, about 450 mg/day
to about 1,000 mg/day, about 500 mg/day to about 1,000 mg/day, about 50 mg/day to
about 1,500 mg/day, about 100 mg/day to about 1,500 mg/day, about 150 mg/day to about
1,500 mg/day, about 200 mg/day to about 1,500 mg/day, about 250 mg/day to about 1,500
mg/day, about 300 mg/day to about 1,500 mg/day, about 350 mg/day to about 1,500 mg/day,
about 400 mg/day to about 1,500 mg/day, about 450 mg/day to about 1,500 mg/day, about
500 mg/day to about 1,500 mg/day, about 1,000 mg/day to about 3,000 mg/day, about
1,100 mg/day to about 3,000 mg/day, about 1,200 mg/day to about 3,000 mg/day, about
1,3000 mg/day to about 3,000 mg/day, about 1,400 mg/day to about 3,000 mg/day, about
1,500 mg/day to about 3,000 mg/day, about 1,600 mg/day to about 3,000 mg/day, about
1,700 mg/day to about 3,000 mg/day, about 1,800 mg/day to about 3,000 mg/day, about
1,900 mg/day to about 3,000 mg/day, or about 2,000 mg/day to about 3,000 mg/day.
[0088] In other aspects of this embodiment, a therapeutically effective amount of a methylxanthine
disclosed herein generally is in the range of about 0. 001 mg/kg/day to about 100
mg/kg/day. In aspects of this embodiment, an effective amount of a methylxanthine
disclosed herein may be,
e.g., at least 0.001 mg/kg/day, at least 0.01 mg/kg/day, at least 0.1 mg/kg/day, at least
1.0 mg/kg/day, at least 5.0 mg/kg/day, at least 10 mg/kg/day, at least 15 mg/kg/day,
at least 20 mg/kg/day, at least 25 mg/kg/day, at least 30 mg/kg/day, at least 35 mg/kg/day,
at least 40 mg/kg/day, at least 45 mg/kg/day, or at least 50 mg/kg/day. In other aspects
of this embodiment, an effective amount of a methylxanthine disclosed herein may be
in the range of,
e.g., about 0.001 mg/kg/day to about 10 mg/kg/day, about 0.001 mg/kg/day to about 15
mg/kg/day, about 0.001 mg/kg/day to about 20 mg/kg/day, about 0.001 mg/kg/day to about
25 mg/kg/day, about 0.001 mg/kg/day to about 30 mg/kg/day, about 0.001 mg/kg/day to
about 35 mg/kg/day, about 0.001 mg/kg/day to about 40 mg/kg/day, about 0.001 mg/kg/day
to about 45 mg/kg/day, about 0.001 mg/kg/day to about 50 mg/kg/day, about 0.001 mg/kg/day
to about 75 mg/kg/day, or about 0.001 mg/kg/day to about 100 mg/kg/day. In yet other
aspects of this embodiment, an effective amount of a methylxanthine disclosed herein
may be in the range of,
e.g., about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to about 15 mg/kg/day,
about 0.01 mg/kg/day to about 20 mg/kg/day, about 0.01 mg/kg/day to about 25 mg/kg/day,
about 0.01 mg/kg/day to about 30 mg/kg/day, about 0.01 mg/kg/day to about 35 mg/kg/day,
about 0.01 mg/kg/day to about 40 mg/kg/day, about 0.01 mg/kg/day to about 45 mg/kg/day,
about 0.01 mg/kg/day to about 50 mg/kg/day, about 0.01 mg/kg/day to about 75 mg/kg/day,
or about 0.01 mg/kg/day to about 100 mg/kg/day. In still other aspects of this embodiment,
an effective amount of a methylxanthine disclosed herein may be in the range of,
e.g., about 0.1 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about 15 mg/kg/day,
about 0.1 mg/kg/day to about 20 mg/kg/day, about 0.1 mg/kg/day to about 25 mg/kg/day,
about 0.1 mg/kg/day to about 30 mg/kg/day, about 0.1 mg/kg/day to about 35 mg/kg/day,
about 0.1 mg/kg/day to about 40 mg/kg/day, about 0.1 mg/kg/day to about 45 mg/kg/day,
about 0.1 mg/kg/day to about 50 mg/kg/day, about 0.1 mg/kg/day to about 75 mg/kg/day,
or about 0.1 mg/kg/day to about 100 mg/kg/day.
[0089] In other aspects of this embodiment, an effective amount of a methylxanthine disclosed
herein may be in the range of,
e.g., about 1 mg/kg/day to about 10 mg/kg/day, about 1 mg/kg/day to about 15 mg/kg/day,
about 1 mg/kg/day to about 20 mg/kg/day, about 1 mg/kg/day to about 25 mg/kg/day,
about 1 mg/kg/day to about 30 mg/kg/day, about 1 mg/kg/day to about 35 mg/kg/day,
about 1 mg/kg/day to about 40 mg/kg/day, about 1 mg/kg/day to about 45 mg/kg/day,
about 1 mg/kg/day to about 50 mg/kg/day, about 1 mg/kg/day to about 75 mg/kg/day,
or about 1 mg/kg/day to about 100 mg/kg/day. In yet other aspects of this embodiment,
an effective amount of a methylxanthine disclosed herein may be in the range of,
e.g., about 5 mg/kg/day to about 10 mg/kg/day, about 5 mg/kg/day to about 15 mg/kg/day,
about 5 mg/kg/day to about 20 mg/kg/day, about 5 mg/kg/day to about 25 mg/kg/day,
about 5 mg/kg/day to about 30 mg/kg/day, about 5 mg/kg/day to about 35 mg/kg/day,
about 5 mg/kg/day to about 40 mg/kg/day, about 5 mg/kg/day to about 45 mg/kg/day,
about 5 mg/kg/day to about 50 mg/kg/day, about 5 mg/kg/day to about 75 mg/kg/day,
or about 5 mg/kg/day to about 100 mg/kg/day.
[0090] In other aspects of this embodiment, a therapeutically effective amount of a methylxanthine
disclosed herein generally is in the range of about 1 mg/day to about 3,000 mg/day.
In aspects of this embodiment, an effective amount of a methylxanthine disclosed herein
may be,
e.g., at least 50 mg/day, at least 100 mg/day, at least 150 mg/day, at least 200 mg/day,
at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at least 400 mg/day,
at least 450 mg/day, at least 500 mg/day, at least 550 mg/day, at least 600 mg/day,
at least 650 mg/day, at least 700 mg/day, at least 750 mg/day, at least 800 mg/day,
at least 850 mg/day, at least 900 mg/day, at least 950 mg/day, at least 1,000 mg/day,
at least 1,50 mg/day, at least 1,100 mg/day, at least 1,150 mg/day, at least 1,200
mg/day, at least 1,250 mg/day, at least 1,300 mg/day, at least 1,350 mg/day, at least
1,400 mg/day, at least 1,450 mg/day, at least 1,500 mg/day, at least 1,600 mg/day,
at least 1,700 mg/day, at least 1,800 mg/day, at least 1,900 mg/day, at least 2,000
mg/day, at least 2,100 mg/day, at least 2,200 mg/day, at least 2,300 mg/day, at least
2,400 mg/day, at least 2,500 mg/day, at least 2,600 mg/day, at least 2,700 mg/day,
at least 2,800 mg/day, at least 2,900 mg/day, or at least 3,000 mg/day. In yet other
aspects of this embodiment, an effective amount of a methylxanthine disclosed herein
may be between,
e.g., about 50 mg/day to about 1,000 mg/day, about 100 mg/day to about 1,000 mg/day,
about 150 mg/day to about 1,000 mg/day, about 200 mg/day to about 1,000 mg/day, about
250 mg/day to about 1,000 mg/day, about 300 mg/day to about 1,000 mg/day, about 350
mg/day to about 1,000 mg/day, about 400 mg/day to about 1,000 mg/day, about 450 mg/day
to about 1,000 mg/day, about 500 mg/day to about 1,000 mg/day, about 50 mg/day to
about 1,500 mg/day, about 100 mg/day to about 1,500 mg/day, about 150 mg/day to about
1,500 mg/day, about 200 mg/day to about 1,500 mg/day, about 250 mg/day to about 1,500
mg/day, about 300 mg/day to about 1,500 mg/day, about 350 mg/day to about 1,500 mg/day,
about 400 mg/day to about 1,500 mg/day, about 450 mg/day to about 1,500 mg/day, about
500 mg/day to about 1,500 mg/day, about 1,000 mg/day to about 3,000 mg/day, about
1,100 mg/day to about 3,000 mg/day, about 1,200 mg/day to about 3,000 mg/day, about
1,3000 mg/day to about 3,000 mg/day, about 1,400 mg/day to about 3,000 mg/day, about
1,500 mg/day to about 3,000 mg/day, about 1,600 mg/day to about 3,000 mg/day, about
1,700 mg/day to about 3,000 mg/day, about 1,800 mg/day to about 3,000 mg/day, about
1,900 mg/day to about 3,000 mg/day, or about 2,000 mg/day to about 3,000 mg/day.
[0091] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a non-opiate antitussive disclosed herein generally is in the
range of about 0.01 mg/kg/day to about 50 mg/kg/day. In other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of a non-opiate antitussive
disclosed herein may be,
e.g., at least 0.01 mg/kg/day, at least 0.025 mg/kg/day, at least 0.05 mg/kg/day, at
least 0.075 mg/kg/day, at least 0.1 mg/kg/day, at least 0.25 mg/kg/day, at least 0.5
mg/kg/day, at least 0.75 mg/kg/day, at least 1.0 mg/kg/day, at least 2.5 mg/kg/day,
at least 5.0 mg/kg/day, at least 7.5 mg/kg/day, at least 10 mg/kg/day, at least 25
mg/kg/day, or at least 50 mg/kg/day. In yet other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of a non-opiate antitussive disclosed herein
may be,
e.g., at least 0.1 mg/kg/day, at least 0.2 mg/kg/day, at least 0.3 mg/kg/day, at least
0.4 mg/kg/day, at least 0.5 mg/kg/day, at least 0.6 mg/kg/day, at least 0.7 mg/kg/day,
at least 0.8 mg/kg/day, at least 0.9 mg/kg/day, at least 1.0 mg/kg/day, at least 1.25
mg/kg/day, at least 1.5 mg/kg/day, at least 1.75 mg/kg/day, at least 2.0 mg/kg/day,
at least 2.25 mg/kg/day, at least 2.5 mg/kg/day, at least 2.75 mg/kg/day, at least
3.0 mg/kg/day, at least 3.25 mg/kg/day, at least 3.5 mg/kg/day, at least 3.75 mg/kg/day,
at least 4.0 mg/kg/day, at least 4.25 mg/kg/day, at least 4.5 mg/kg/day, at least
4.75 mg/kg/day, or at least 5.0 mg/kg/day. In yet other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of a non-opiate antitussive
disclosed herein may be,
e.g., about 0.01 mg/kg/day to about 0.1 mg/kg/day, about 0.01 mg/kg/day to about 0.5
mg/kg/day, about 0.01 mg/kg/day to about 1 mg/kg/day, about 0.01 mg/kg/day to about
5 mg/kg/day, about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about
0.1 mg/kg/day, about 0.1 mg/kg/day to about 0.5 mg/kg/day, about 0.1 mg/kg/day to
about 1 mg/kg/day, about 0.1 mg/kg/day to about 5 mg/kg/day, or about 0.1 mg/kg/day
to about 10 mg/kg/day.
[0092] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a non-opiate antitussive disclosed herein generally is in the
range of about 1 mg/day to about 500 mg/day. In other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of a non-opiate antitussive
disclosed herein may be,
e.g., at least 1 mg/day, at least 5 mg/day, at least 10 mg/day, at least 25 mg/day, at
least 50 mg/day, at least 75 mg/day, at least 100 mg/day, at least 150 mg/day, at
least 200 mg/day, at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at
least 400 mg/day, at least 450 mg/day, or at least 500 mg/day. In yet other aspects
of this embodiment, in conjunction with a methylxanthine, an effective amount of a
non-opiate antitussive disclosed herein may be,
e.g., about 1 mg/day to about 100 mg/day, about 1 mg/day to about 150 mg/day, about 1
mg/day to about 200 mg/day, about 1 mg/day to about 250 mg/day, about 1 mg/day to
about 300 mg/day, about 1 mg/day to about 350 mg/day, about 1 mg/day to about 400
mg/day, about 1 mg/day to about 450 mg/day, about 1 mg/day to about 500 mg/day, about
10 mg/day to about 100 mg/day, about 10 mg/day to about 150 mg/day, about 10 mg/day
to about 200 mg/day, about 10 mg/day to about 250 mg/day, about 10 mg/day to about
300 mg/day, about 10 mg/day to about 350 mg/day, about 10 mg/day to about 400 mg/day,
about 10 mg/day to about 450 mg/day, or about 10 mg/day to about 500 mg/day.
[0093] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of an opiate antitussive disclosed herein generally is in the range
of about 0.01 mg/kg/day to about 10 mg/kg/day. In other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of an opiate antitussive
disclosed herein may be,
e.g., at least 0.01 mg/kg/day, at least 0.025 mg/kg/day, at least 0.05 mg/kg/day, at
least 0.075 mg/kg/day, at least 0.1 mg/kg/day, at least 0.25 mg/kg/day, at least 0.5
mg/kg/day, at least 0.75 mg/kg/day, at least 1.0 mg/kg/day, at least 2.5 mg/kg/day,
at least 5.0 mg/kg/day, at least 7.5 mg/kg/day, or at least 10 mg/kg/day. In yet other
aspects of this embodiment, in conjunction with a methylxanthine, an effective amount
of an opiate antitussive disclosed herein may be,
e.g., about 0.01 mg/kg/day to about 0.1 mg/kg/day, about 0.01 mg/kg/day to about 0.5
mg/kg/day, about 0.01 mg/kg/day to about 1 mg/kg/day, about 0.01 mg/kg/day to about
5 mg/kg/day, about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about
0.1 mg/kg/day, about 0.1 mg/kg/day to about 0.5 mg/kg/day, about 0.1 mg/kg/day to
about 1 mg/kg/day, about 0.1 mg/kg/day to about 5 mg/kg/day, or about 0.1 mg/kg/day
to about 10 mg/kg/day.
[0094] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of an opiate antitussive disclosed herein generally is in the range
of about 0.1 mg/day to about 100 mg/day. In other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of an opiate antitussive disclosed herein
may be,
e.g., at least 0.1 mg/day, at least 0.5 mg/day, at least 1 mg/day, at least 5 mg/day,
at least 10 mg/day, at least 20 mg/day, at least 30 mg/day, at least 40 mg/day, at
least 50 mg/day, at least 60 mg/day, at least 70 mg/day, at least 80 mg/day, at least
90 mg/day, or at least 100 mg/day. In yet other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of an opiate antitussive disclosed herein
may be,
e.g., about 0.1 mg/day to about 10 mg/day, about 0.1 mg/day to about 20 mg/day, about
0.1 mg/day to about 40 mg/day, about 0.1 mg/day to about 60 mg/day, about 0.1 mg/day
to about 80 mg/day, about 0.1 mg/day to about 100 mg/day, about 1 mg/day to about
10 mg/day, about 1 mg/day to about 20 mg/day, about 1 mg/day to about 40 mg/day, about
1 mg/day to about 60 mg/day, about 1 mg/day to about 80 mg/day, about 1 mg/day to
about 100 mg/day, about 2.5 mg/day to about 10 mg/day, about 2.5 mg/day to about 20
mg/day, about 2.5 mg/day to about 40 mg/day, about 2.5 mg/day to about 60 mg/day,
about 2.5 mg/day to about 80 mg/day, or about 2.5 mg/day to about 100 mg/day.
[0095] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed
herein generally is in the range of about 0. 001 mg/kg/day to about 100 mg/kg/day.
In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed
herein may be,
e.g., at least 0.001 mg/kg/day, at least 0.01 mg/kg/day, at least 0.1 mg/kg/day, at least
1.0 mg/kg/day, at least 5.0 mg/kg/day, at least 10 mg/kg/day, at least 15 mg/kg/day,
at least 20 mg/kg/day, at least 25 mg/kg/day, at least 30 mg/kg/day, at least 35 mg/kg/day,
at least 40 mg/kg/day, at least 45 mg/kg/day, or at least 50 mg/kg/day. In other aspects
of this embodiment, in conjunction with a methylxanthine, a therapeutically effective
amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed herein
may be in the range of,
e.g., about 0.001 mg/kg/day to about 10 mg/kg/day, about 0.001 mg/kg/day to about 15
mg/kg/day, about 0.001 mg/kg/day to about 20 mg/kg/day, about 0.001 mg/kg/day to about
25 mg/kg/day, about 0.001 mg/kg/day to about 30 mg/kg/day, about 0.001 mg/kg/day to
about 35 mg/kg/day, about 0.001 mg/kg/day to about 40 mg/kg/day, about 0.001 mg/kg/day
to about 45 mg/kg/day, about 0.001 mg/kg/day to about 50 mg/kg/day, about 0.001 mg/kg/day
to about 75 mg/kg/day, or about 0.001 mg/kg/day to about 100 mg/kg/day. In yet other
aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed
herein may be in the range of,
e.g., about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to about 15 mg/kg/day,
about 0.01 mg/kg/day to about 20 mg/kg/day, about 0.01 mg/kg/day to about 25 mg/kg/day,
about 0.01 mg/kg/day to about 30 mg/kg/day, about 0.01 mg/kg/day to about 35 mg/kg/day,
about 0.01 mg/kg/day to about 40 mg/kg/day, about 0.01 mg/kg/day to about 45 mg/kg/day,
about 0.01 mg/kg/day to about 50 mg/kg/day, about 0.01 mg/kg/day to about 75 mg/kg/day,
or about 0.01 mg/kg/day to about 100 mg/kg/day. In still other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a decongestant,
an expectorant, and/or a mucolytic agent disclosed herein may be in the range of,
e.g., about 0.1 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about 15 mg/kg/day,
about 0.1 mg/kg/day to about 20 mg/kg/day, about 0.1 mg/kg/day to about 25 mg/kg/day,
about 0.1 mg/kg/day to about 30 mg/kg/day, about 0.1 mg/kg/day to about 35 mg/kg/day,
about 0.1 mg/kg/day to about 40 mg/kg/day, about 0.1 mg/kg/day to about 45 mg/kg/day,
about 0.1 mg/kg/day to about 50 mg/kg/day, about 0.1 mg/kg/day to about 75 mg/kg/day,
or about 0.1 mg/kg/day to about 100 mg/kg/day.
[0096] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed
herein may be in the range of,
e.g., about 1 mg/kg/day to about 10 mg/kg/day, about 1 mg/kg/day to about 15 mg/kg/day,
about 1 mg/kg/day to about 20 mg/kg/day, about 1 mg/kg/day to about 25 mg/kg/day,
about 1 mg/kg/day to about 30 mg/kg/day, about 1 mg/kg/day to about 35 mg/kg/day,
about 1 mg/kg/day to about 40 mg/kg/day, about 1 mg/kg/day to about 45 mg/kg/day,
about 1 mg/kg/day to about 50 mg/kg/day, about 1 mg/kg/day to about 75 mg/kg/day,
or about 1 mg/kg/day to about 100 mg/kg/day. In yet other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a decongestant,
an expectorant, and/or a mucolytic agent disclosed herein may be in the range of,
e.g., about 5 mg/kg/day to about 10 mg/kg/day, about 5 mg/kg/day to about 15 mg/kg/day,
about 5 mg/kg/day to about 20 mg/kg/day, about 5 mg/kg/day to about 25 mg/kg/day,
about 5 mg/kg/day to about 30 mg/kg/day, about 5 mg/kg/day to about 35 mg/kg/day,
about 5 mg/kg/day to about 40 mg/kg/day, about 5 mg/kg/day to about 45 mg/kg/day,
about 5 mg/kg/day to about 50 mg/kg/day, about 5 mg/kg/day to about 75 mg/kg/day,
or about 5 mg/kg/day to about 100 mg/kg/day.
[0097] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed
herein generally is in the range of about 1 mg/day to about 6,000 mg/day. In other
aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a decongestant, an expectorant, and/or a mucolytic agent disclosed
herein may be,
e.g., at least 50 mg/day, at least 100 mg/day, at least 150 mg/day, at least 200 mg/day,
at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at least 400 mg/day,
at least 450 mg/day, at least 500 mg/day, at least 550 mg/day, at least 600 mg/day,
at least 650 mg/day, at least 700 mg/day, at least 750 mg/day, at least 800 mg/day,
at least 850 mg/day, at least 900 mg/day, at least 950 mg/day, at least 1,000 mg/day,
at least 1,50 mg/day, at least 1,100 mg/day, at least 1,150 mg/day, at least 1,200
mg/day, at least 1,250 mg/day, at least 1,300 mg/day, at least 1,350 mg/day, at least
1,400 mg/day, at least 1,450 mg/day, at least 1,500 mg/day, at least 1,600 mg/day,
at least 1,700 mg/day, at least 1,800 mg/day, at least 1,900 mg/day, at least 2,000
mg/day, at least 2,100 mg/day, at least 2,200 mg/day, at least 2,300 mg/day, at least
2,400 mg/day, at least 2,500 mg/day, at least 2,600 mg/day, at least 2,700 mg/day,
at least 2,800 mg/day, at least 2,900 mg/day, at least 3,000 mg/day, at least 3,500
mg/day, at least 4,000 mg/day, at least 4,500 mg/day, at least 5,000 mg/day, at least
5,500 mg/day, or at least 6,000 mg/day.
[0098] In yet other aspects of this embodiment, in conjunction with a methylxanthine, a
therapeutically effective amount of a decongestant, an expectorant, and/or a mucolytic
agent disclosed herein may be between,
e.g., about 50 mg/day to about 1,000 mg/day, about 100 mg/day to about 1,000 mg/day,
about 150 mg/day to about 1,000 mg/day, about 200 mg/day to about 1,000 mg/day, about
250 mg/day to about 1,000 mg/day, about 300 mg/day to about 1,000 mg/day, about 350
mg/day to about 1,000 mg/day, about 400 mg/day to about 1,000 mg/day, about 450 mg/day
to about 1,000 mg/day, about 500 mg/day to about 1,000 mg/day, about 50 mg/day to
about 1,500 mg/day, about 100 mg/day to about 1,500 mg/day, about 150 mg/day to about
1,500 mg/day, about 200 mg/day to about 1,500 mg/day, about 250 mg/day to about 1,500
mg/day, about 300 mg/day to about 1,500 mg/day, about 350 mg/day to about 1,500 mg/day,
about 400 mg/day to about 1,500 mg/day, about 450 mg/day to about 1,500 mg/day, about
500 mg/day to about 1,500 mg/day, about 1,000 mg/day to about 3,000 mg/day, about
1,100 mg/day to about 3,000 mg/day, about 1,200 mg/day to about 3,000 mg/day, about
1,3000 mg/day to about 3,000 mg/day, about 1,400 mg/day to about 3,000 mg/day, about
1,500 mg/day to about 3,000 mg/day, about 1,600 mg/day to about 3,000 mg/day, about
1,700 mg/day to about 3,000 mg/day, about 1,800 mg/day to about 3,000 mg/day, about
1,900 mg/day to about 3,000 mg/day, about 2,000 mg/day to about 3,000 mg/day, about
1,000 mg/day to about 4,000 mg/day, about 1,100 mg/day to about 4,000 mg/day, about
1,200 mg/day to about 4,000 mg/day, about 1,3000 mg/day to about 4,000 mg/day, about
1,400 mg/day to about 4,000 mg/day, about 1,500 mg/day to about 4,000 mg/day, about
1,600 mg/day to about 4,000 mg/day, about 1,700 mg/day to about 4,000 mg/day, about
1,800 mg/day to about 4,000 mg/day, about 1,900 mg/day to about 4,000 mg/day, about
2,000 mg/day to about 4,000 mg/day, about 2,500 mg/day to about 4,000 mg/day, about
3,000 mg/day to about 4,000 mg/day, about 1,000 mg/day to about 5,000 mg/day, about
1,100 mg/day to about 5,000 mg/day, about 1,200 mg/day to about 5,000 mg/day, about
1,3000 mg/day to about 5,000 mg/day, about 1,400 mg/day to about 5,000 mg/day, about
1,500 mg/day to about 5,000 mg/day, about 1,600 mg/day to about 5,000 mg/day, about
1,700 mg/day to about 5,000 mg/day, about 1,800 mg/day to about 5,000 mg/day, about
1,900 mg/day to about 5,000 mg/day, about 2,000 mg/day to about 5,000 mg/day, about
2,500 mg/day to about 5,000 mg/day, about 3,000 mg/day to about 5,000 mg/day, about
3,500 mg/day to about 5,000 mg/day, about 4,000 mg/day to about 5,000 mg/day, about
1,000 mg/day to about 6,000 mg/day, about 1,100 mg/day to about 6,000 mg/day, about
1,200 mg/day to about 6,000 mg/day, about 1,3000 mg/day to about 6,000 mg/day, about
1,400 mg/day to about 6,000 mg/day, about 1,500 mg/day to about 6,000 mg/day, about
1,600 mg/day to about 6,000 mg/day, about 1,700 mg/day to about 6,000 mg/day, about
1,800 mg/day to about 6,000 mg/day, about 1,900 mg/day to about 6,000 mg/day, about
2,000 mg/day to about 6,000 mg/day, about 2,500 mg/day to about 6,000 mg/day, about
3,000 mg/day to about 6,000 mg/day, about 3,500 mg/day to about 6,000 mg/day, about
4,000 mg/day to about 6,000 mg/day, about 4,500 mg/day to about 6,000 mg/day, or about
5,000 mg/day to about 6,000 mg/day.
[0099] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of an antihistamine disclosed herein generally is in the range of
about 0.001 mg/kg/day to about 50 mg/kg/day. In other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of an antihistamine disclosed
herein may be,
e.g., at least 0.001 mg/kg/day, at least 0.0025 mg/kg/day, at least 0.005 mg/kg/day,
at least 0.0075 mg/kg/day, at least 0.01 mg/kg/day, at least 0.025 mg/kg/day, at least
0.05 mg/kg/day, at least 0.075 mg/kg/day, at least 0.1 mg/kg/day, at least 0.25 mg/kg/day,
at least 0.5 mg/kg/day, at least 0.75 mg/kg/day, at least 1.0 mg/kg/day, at least
2.5 mg/kg/day, at least 5.0 mg/kg/day, at least 7.5 mg/kg/day, at least 10 mg/kg/day,
at least 25 mg/kg/day, or at least 50 mg/kg/day. In yet other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of an antihistamine disclosed
herein may be,
e.g., at least 0.1 mg/kg/day, at least 0.2 mg/kg/day, at least 0.3 mg/kg/day, at least
0.4 mg/kg/day, at least 0.5 mg/kg/day, at least 0.6 mg/kg/day, at least 0.7 mg/kg/day,
at least 0.8 mg/kg/day, at least 0.9 mg/kg/day, at least 1.0 mg/kg/day, at least 1.25
mg/kg/day, at least 1.5 mg/kg/day, at least 1.75 mg/kg/day, at least 2.0 mg/kg/day,
at least 2.25 mg/kg/day, at least 2.5 mg/kg/day, at least 2.75 mg/kg/day, at least
3.0 mg/kg/day, at least 3.25 mg/kg/day, at least 3.5 mg/kg/day, at least 3.75 mg/kg/day,
at least 4.0 mg/kg/day, at least 4.25 mg/kg/day, at least 4.5 mg/kg/day, at least
4.75 mg/kg/day, or at least 5.0 mg/kg/day. In yet other aspects of this embodiment,
in conjunction with a methylxanthine, an effective amount of an antihistamine disclosed
herein may be,
e.g., about 0.001 mg/kg/day to about 0.1 mg/kg/day, about 0.001 mg/kg/day to about 0.5
mg/kg/day, about 0.001 mg/kg/day to about 1 mg/kg/day, about 0.001 mg/kg/day to about
5 mg/kg/day, about 0.001 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to
about 0.1 mg/kg/day, about 0.01 mg/kg/day to about 0.5 mg/kg/day, about 0.01 mg/kg/day
to about 1 mg/kg/day, about 0.01 mg/kg/day to about 5 mg/kg/day, about 0.01 mg/kg/day
to about 10 mg/kg/day, about 0.1 mg/kg/day to about 0.1 mg/kg/day, about 0.1 mg/kg/day
to about 0.5 mg/kg/day, about 0.1 mg/kg/day to about 1 mg/kg/day, about 0.1 mg/kg/day
to about 5 mg/kg/day, or about 0.1 mg/kg/day to about 10 mg/kg/day.
[0100] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of an antihistamine disclosed herein generally is in the range of
about 1 mg/day to about 500 mg/day. In other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of an antihistamine disclosed herein may
be,
e.g., at least 1 mg/day, at least 5 mg/day, at least 10 mg/day, at least 25 mg/day, at
least 50 mg/day, at least 75 mg/day, at least 100 mg/day, at least 150 mg/day, at
least 200 mg/day, at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at
least 400 mg/day, at least 450 mg/day, or at least 500 mg/day. In yet other aspects
of this embodiment, in conjunction with a methylxanthine, an effective amount of an
antihistamine disclosed herein may be,
e.g., about 1 mg/day to about 100 mg/day, about 1 mg/day to about 150 mg/day, about 1
mg/day to about 200 mg/day, about 1 mg/day to about 250 mg/day, about 1 mg/day to
about 300 mg/day, about 1 mg/day to about 350 mg/day, about 1 mg/day to about 400
mg/day, about 1 mg/day to about 450 mg/day, about 1 mg/day to about 500 mg/day, about
10 mg/day to about 100 mg/day, about 10 mg/day to about 150 mg/day, about 10 mg/day
to about 200 mg/day, about 10 mg/day to about 250 mg/day, about 10 mg/day to about
300 mg/day, about 10 mg/day to about 350 mg/day, about 10 mg/day to about 400 mg/day,
about 10 mg/day to about 450 mg/day, or about 10 mg/day to about 500 mg/day.
[0101] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a NSAID disclosed herein generally is in the range of about 0.
001 mg/kg/day to about 100 mg/kg/day. In aspects of this embodiment, an effective
amount of a methylxanthine disclosed herein may be,
e.g., at least 0.001 mg/kg/day, at least 0.01 mg/kg/day, at least 0.1 mg/kg/day, at least
1.0 mg/kg/day, at least 5.0 mg/kg/day, at least 10 mg/kg/day, at least 15 mg/kg/day,
at least 20 mg/kg/day, at least 25 mg/kg/day, at least 30 mg/kg/day, at least 35 mg/kg/day,
at least 40 mg/kg/day, at least 45 mg/kg/day, or at least 50 mg/kg/day. In other aspects
of this embodiment, in conjunction with a methylxanthine, a therapeutically effective
amount of a NSAID disclosed herein may be in the range of, e.g., about 0.001 mg/kg/day
to about 10 mg/kg/day, about 0.001 mg/kg/day to about 15 mg/kg/day, about 0.001 mg/kg/day
to about 20 mg/kg/day, about 0.001 mg/kg/day to about 25 mg/kg/day, about 0.001 mg/kg/day
to about 30 mg/kg/day, about 0.001 mg/kg/day to about 35 mg/kg/day, about 0.001 mg/kg/day
to about 40 mg/kg/day, about 0.001 mg/kg/day to about 45 mg/kg/day, about 0.001 mg/kg/day
to about 50 mg/kg/day, about 0.001 mg/kg/day to about 75 mg/kg/day, or about 0.001
mg/kg/day to about 100 mg/kg/day. In yet other aspects of this embodiment, in conjunction
with a methylxanthine, a therapeutically effective amount of a NSAID disclosed herein
may be in the range of,
e.g., about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to about 15 mg/kg/day,
about 0.01 mg/kg/day to about 20 mg/kg/day, about 0.01 mg/kg/day to about 25 mg/kg/day,
about 0.01 mg/kg/day to about 30 mg/kg/day, about 0.01 mg/kg/day to about 35 mg/kg/day,
about 0.01 mg/kg/day to about 40 mg/kg/day, about 0.01 mg/kg/day to about 45 mg/kg/day,
about 0.01 mg/kg/day to about 50 mg/kg/day, about 0.01 mg/kg/day to about 75 mg/kg/day,
or about 0.01 mg/kg/day to about 100 mg/kg/day. In still other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a NSAID
disclosed herein may be in the range of,
e.g., about 0.1 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about 15 mg/kg/day,
about 0.1 mg/kg/day to about 20 mg/kg/day, about 0.1 mg/kg/day to about 25 mg/kg/day,
about 0.1 mg/kg/day to about 30 mg/kg/day, about 0.1 mg/kg/day to about 35 mg/kg/day,
about 0.1 mg/kg/day to about 40 mg/kg/day, about 0.1 mg/kg/day to about 45 mg/kg/day,
about 0.1 mg/kg/day to about 50 mg/kg/day, about 0.1 mg/kg/day to about 75 mg/kg/day,
or about 0.1 mg/kg/day to about 100 mg/kg/day.
[0102] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a NSAID disclosed herein may be in the range of,
e.g., about 1 mg/kg/day to about 10 mg/kg/day, about 1 mg/kg/day to about 15 mg/kg/day,
about 1 mg/kg/day to about 20 mg/kg/day, about 1 mg/kg/day to about 25 mg/kg/day,
about 1 mg/kg/day to about 30 mg/kg/day, about 1 mg/kg/day to about 35 mg/kg/day,
about 1 mg/kg/day to about 40 mg/kg/day, about 1 mg/kg/day to about 45 mg/kg/day,
about 1 mg/kg/day to about 50 mg/kg/day, about 1 mg/kg/day to about 75 mg/kg/day,
or about 1 mg/kg/day to about 100 mg/kg/day. In yet other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a NSAID
disclosed herein may be in the range of, e.g., about 5 mg/kg/day to about 10 mg/kg/day,
about 5 mg/kg/day to about 15 mg/kg/day, about 5 mg/kg/day to about 20 mg/kg/day,
about 5 mg/kg/day to about 25 mg/kg/day, about 5 mg/kg/day to about 30 mg/kg/day,
about 5 mg/kg/day to about 35 mg/kg/day, about 5 mg/kg/day to about 40 mg/kg/day,
about 5 mg/kg/day to about 45 mg/kg/day, about 5 mg/kg/day to about 50 mg/kg/day,
about 5 mg/kg/day to about 75 mg/kg/day, or about 5 mg/kg/day to about 100 mg/kg/day.
[0103] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a NSAID disclosed herein generally is in the range of about 1
mg/day to about 1,200 mg/day. In aspects of this embodiment, in conjunction with a
methylxanthine, a therapeutically effective amount of a NSAID disclosed herein may
be,
e.g., at least 50 mg/day, at least 100 mg/day, at least 150 mg/day, at least 200 mg/day,
at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at least 400 mg/day,
at least 450 mg/day, at least 500 mg/day, at least 550 mg/day, at least 600 mg/day,
at least 650 mg/day, at least 700 mg/day, at least 750 mg/day, at least 800 mg/day,
at least 850 mg/day, at least 900 mg/day, at least 950 mg/day, at least 1,000 mg/day,
at least 1,050 mg/day, at least 1,100 mg/day, at least 1,150 mg/day, or at least 1,200
mg/day. In yet other aspects of this embodiment, in conjunction with a methylxanthine,
a therapeutically effective amount of a NSAID disclosed herein may be between, e.g.,
about 50 mg/day to about 800 mg/day, about 100 mg/day to about 800 mg/day, about 150
mg/day to about 800 mg/day, about 200 mg/day to about 800 mg/day, about 250 mg/day
to about 800 mg/day, about 300 mg/day to about 800 mg/day, about 350 mg/day to about
800 mg/day, about 400 mg/day to about 800 mg/day, about 450 mg/day to about 800 mg/day,
about 500 mg/day to about 800 mg/day, about 50 mg/day to about 1,000 mg/day, about
100 mg/day to about 1,000 mg/day, about 150 mg/day to about 1,000 mg/day, about 200
mg/day to about 1,000 mg/day, about 250 mg/day to about 1,000 mg/day, about 300 mg/day
to about 1,000 mg/day, about 350 mg/day to about 1,000 mg/day, about 400 mg/day to
about 1,000 mg/day, about 450 mg/day to about 1,000 mg/day, about 500 mg/day to about
1,000 mg/day, about 50 mg/day to about 1,200 mg/day, about 100 mg/day to about 1,200
mg/day, about 150 mg/day to about 1,200 mg/day, about 200 mg/day to about 1,200 mg/day,
about 250 mg/day to about 1,200 mg/day, about 300 mg/day to about 1,200 mg/day, about
350 mg/day to about 1,200 mg/day, about 400 mg/day to about 1,200 mg/day, about 450
mg/day to about 1,200 mg/day, about 500 mg/day to about 1,200 mg/day.
[0104] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a neuropathic pain agent disclosed herein generally is in the
range of about 0. 001 mg/kg/day to about 100 mg/kg/day. In aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a neuropathic
pain agent disclosed herein may be,
e.g., at least 0.001 mg/kg/day, at least 0.01 mg/kg/day, at least 0.1 mg/kg/day, at least
1.0 mg/kg/day, at least 5.0 mg/kg/day, at least 10 mg/kg/day, at least 15 mg/kg/day,
at least 20 mg/kg/day, at least 25 mg/kg/day, at least 30 mg/kg/day, at least 35 mg/kg/day,
at least 40 mg/kg/day, at least 45 mg/kg/day, or at least 50 mg/kg/day. In other aspects
of this embodiment, in conjunction with a methylxanthine, a therapeutically effective
amount of a neuropathic pain agent disclosed herein may be in the range of,
e.g., about 0.001 mg/kg/day to about 10 mg/kg/day, about 0.001 mg/kg/day to about 15
mg/kg/day, about 0.001 mg/kg/day to about 20 mg/kg/day, about 0.001 mg/kg/day to about
25 mg/kg/day, about 0.001 mg/kg/day to about 30 mg/kg/day, about 0.001 mg/kg/day to
about 35 mg/kg/day, about 0.001 mg/kg/day to about 40 mg/kg/day, about 0.001 mg/kg/day
to about 45 mg/kg/day, about 0.001 mg/kg/day to about 50 mg/kg/day, about 0.001 mg/kg/day
to about 75 mg/kg/day, or about 0.001 mg/kg/day to about 100 mg/kg/day. In yet other
aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a neuropathic pain agent disclosed herein may be in the range
of,
e.g., about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to about 15 mg/kg/day,
about 0.01 mg/kg/day to about 20 mg/kg/day, about 0.01 mg/kg/day to about 25 mg/kg/day,
about 0.01 mg/kg/day to about 30 mg/kg/day, about 0.01 mg/kg/day to about 35 mg/kg/day,
about 0.01 mg/kg/day to about 40 mg/kg/day, about 0.01 mg/kg/day to about 45 mg/kg/day,
about 0.01 mg/kg/day to about 50 mg/kg/day, about 0.01 mg/kg/day to about 75 mg/kg/day,
or about 0.01 mg/kg/day to about 100 mg/kg/day. In still other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a neuropathic
pain agent disclosed herein may be in the range of,
e.g., about 0.1 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about 15 mg/kg/day,
about 0.1 mg/kg/day to about 20 mg/kg/day, about 0.1 mg/kg/day to about 25 mg/kg/day,
about 0.1 mg/kg/day to about 30 mg/kg/day, about 0.1 mg/kg/day to about 35 mg/kg/day,
about 0.1 mg/kg/day to about 40 mg/kg/day, about 0.1 mg/kg/day to about 45 mg/kg/day,
about 0.1 mg/kg/day to about 50 mg/kg/day, about 0.1 mg/kg/day to about 75 mg/kg/day,
or about 0.1 mg/kg/day to about 100 mg/kg/day.
[0105] In other aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a neuropathic pain agent disclosed herein may be in the range
of,
e.g., about 1 mg/kg/day to about 10 mg/kg/day, about 1 mg/kg/day to about 15 mg/kg/day,
about 1 mg/kg/day to about 20 mg/kg/day, about 1 mg/kg/day to about 25 mg/kg/day,
about 1 mg/kg/day to about 30 mg/kg/day, about 1 mg/kg/day to about 35 mg/kg/day,
about 1 mg/kg/day to about 40 mg/kg/day, about 1 mg/kg/day to about 45 mg/kg/day,
about 1 mg/kg/day to about 50 mg/kg/day, about 1 mg/kg/day to about 75 mg/kg/day,
or about 1 mg/kg/day to about 100 mg/kg/day. In yet other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a neuropathic
pain agent disclosed herein may be in the range of,
e.g., about 5 mg/kg/day to about 10 mg/kg/day, about 5 mg/kg/day to about 15 mg/kg/day,
about 5 mg/kg/day to about 20 mg/kg/day, about 5 mg/kg/day to about 25 mg/kg/day,
about 5 mg/kg/day to about 30 mg/kg/day, about 5 mg/kg/day to about 35 mg/kg/day,
about 5 mg/kg/day to about 40 mg/kg/day, about 5 mg/kg/day to about 45 mg/kg/day,
about 5 mg/kg/day to about 50 mg/kg/day, about 5 mg/kg/day to about 75 mg/kg/day,
or about 5 mg/kg/day to about 100 mg/kg/day.
[0106] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a neuropathic pain agent disclosed herein generally is in the
range of about 1 mg/day to about 6,000 mg/day. In other aspects of this embodiment,
in conjunction with a methylxanthine, a therapeutically effective amount of a neuropathic
pain agent disclosed herein may be,
e.g., at least 50 mg/day, at least 100 mg/day, at least 150 mg/day, at least 200 mg/day,
at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at least 400 mg/day,
at least 450 mg/day, at least 500 mg/day, at least 550 mg/day, at least 600 mg/day,
at least 650 mg/day, at least 700 mg/day, at least 750 mg/day, at least 800 mg/day,
at least 850 mg/day, at least 900 mg/day, at least 950 mg/day, at least 1,000 mg/day,
at least 1,50 mg/day, at least 1,100 mg/day, at least 1,150 mg/day, at least 1,200
mg/day, at least 1,250 mg/day, at least 1,300 mg/day, at least 1,350 mg/day, at least
1,400 mg/day, at least 1,450 mg/day, at least 1,500 mg/day, at least 1,600 mg/day,
at least 1,700 mg/day, at least 1,800 mg/day, at least 1,900 mg/day, at least 2,000
mg/day, at least 2,100 mg/day, at least 2,200 mg/day, at least 2,300 mg/day, at least
2,400 mg/day, at least 2,500 mg/day, at least 2,600 mg/day, at least 2,700 mg/day,
at least 2,800 mg/day, at least 2,900 mg/day, at least 3,000 mg/day, at least 3,500
mg/day, at least 4,000 mg/day, at least 4,500 mg/day, at least 5,000 mg/day, at least
5,500 mg/day, at least 6,000 mg/day, at least 6,500 mg/day, at least 7,000 mg/day,
at least 7,500 mg/day, or at least 8,000 mg/day.
[0107] In yet other aspects of this embodiment, in conjunction with a methylxanthine, a
therapeutically effective amount of a neuropathic pain agent disclosed herein may
be between,
e.g., about 50 mg/day to about 1,000 mg/day, about 100 mg/day to about 1,000 mg/day,
about 150 mg/day to about 1,000 mg/day, about 200 mg/day to about 1,000 mg/day, about
250 mg/day to about 1,000 mg/day, about 300 mg/day to about 1,000 mg/day, about 350
mg/day to about 1,000 mg/day, about 400 mg/day to about 1,000 mg/day, about 450 mg/day
to about 1,000 mg/day, about 500 mg/day to about 1,000 mg/day, about 50 mg/day to
about 1,500 mg/day, about 100 mg/day to about 1,500 mg/day, about 150 mg/day to about
1,500 mg/day, about 200 mg/day to about 1,500 mg/day, about 250 mg/day to about 1,500
mg/day, about 300 mg/day to about 1,500 mg/day, about 350 mg/day to about 1,500 mg/day,
about 400 mg/day to about 1,500 mg/day, about 450 mg/day to about 1,500 mg/day, about
500 mg/day to about 1,500 mg/day, about 1,000 mg/day to about 3,000 mg/day, about
1,100 mg/day to about 3,000 mg/day, about 1,200 mg/day to about 3,000 mg/day, about
1,3000 mg/day to about 3,000 mg/day, about 1,400 mg/day to about 3,000 mg/day, about
1,500 mg/day to about 3,000 mg/day, about 1,600 mg/day to about 3,000 mg/day, about
1,700 mg/day to about 3,000 mg/day, about 1,800 mg/day to about 3,000 mg/day, about
1,900 mg/day to about 3,000 mg/day, about 2,000 mg/day to about 3,000 mg/day, about
1,000 mg/day to about 4,000 mg/day, about 1,100 mg/day to about 4,000 mg/day, about
1,200 mg/day to about 4,000 mg/day, about 1,3000 mg/day to about 4,000 mg/day, about
1,400 mg/day to about 4,000 mg/day, about 1,500 mg/day to about 4,000 mg/day, about
1,600 mg/day to about 4,000 mg/day, about 1,700 mg/day to about 4,000 mg/day, about
1,800 mg/day to about 4,000 mg/day, about 1,900 mg/day to about 4,000 mg/day, about
2,000 mg/day to about 4,000 mg/day, about 2,500 mg/day to about 4,000 mg/day, about
3,000 mg/day to about 4,000 mg/day, about 1,000 mg/day to about 5,000 mg/day, about
1,100 mg/day to about 5,000 mg/day, about 1,200 mg/day to about 5,000 mg/day, about
1,3000 mg/day to about 5,000 mg/day, about 1,400 mg/day to about 5,000 mg/day, about
1,500 mg/day to about 5,000 mg/day, about 1,600 mg/day to about 5,000 mg/day, about
1,700 mg/day to about 5,000 mg/day, about 1,800 mg/day to about 5,000 mg/day, about
1,900 mg/day to about 5,000 mg/day, about 2,000 mg/day to about 5,000 mg/day, about
2,500 mg/day to about 5,000 mg/day, about 3,000 mg/day to about 5,000 mg/day, about
3,500 mg/day to about 5,000 mg/day, about 4,000 mg/day to about 5,000 mg/day, about
1,000 mg/day to about 6,000 mg/day, about 1,100 mg/day to about 6,000 mg/day, about
1,200 mg/day to about 6,000 mg/day, about 1,3000 mg/day to about 6,000 mg/day, about
1,400 mg/day to about 6,000 mg/day, about 1,500 mg/day to about 6,000 mg/day, about
1,600 mg/day to about 6,000 mg/day, about 1,700 mg/day to about 6,000 mg/day, about
1,800 mg/day to about 6,000 mg/day, about 1,900 mg/day to about 6,000 mg/day, about
2,000 mg/day to about 6,000 mg/day, about 2,500 mg/day to about 6,000 mg/day, about
3,000 mg/day to about 6,000 mg/day, about 3,500 mg/day to about 6,000 mg/day, about
4,000 mg/day to about 6,000 mg/day, about 4,500 mg/day to about 6,000 mg/day, or about
5,000 mg/day to about 6,000 mg/day, about 2,000 mg/day to about 7,000 mg/day, about
2,500 mg/day to about 7,000 mg/day, about 3,000 mg/day to about 7,000 mg/day, about
3,500 mg/day to about 7,000 mg/day, about 4,000 mg/day to about 7,000 mg/day, about
4,500 mg/day to about 7,000 mg/day, about 5,000 mg/day to about 7,000 mg/day, about
5,500 mg/day to about 7,000 mg/day, or about 6,000 mg/day to about 7,000 mg/day, about
2,000 mg/day to about 8,000 mg/day, about 2,500 mg/day to about 8,000 mg/day, about
3,000 mg/day to about 8,000 mg/day, about 3,500 mg/day to about 8,000 mg/day, about
4,000 mg/day to about 8,000 mg/day, about 4,500 mg/day to about 8,000 mg/day, about
5,000 mg/day to about 8,000 mg/day, about 5,500 mg/day to about 8,000 mg/day, about
6,000 mg/day to about 8,000 mg/day, about 6,500 mg/day to about 8,000 mg/day, or about
7,000 mg/day to about 8,000 mg/day.
[0108] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a terpene disclosed herein generally is in the range of about
0.001 mg/kg/day to about 10 mg/kg/day. In other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of a terpene disclosed herein may be,
e.g., at least 0.001 mg/kg/day, at least 0.0025 mg/kg/day, at least 0.005 mg/kg/day,
at least 0.0075 mg/kg/day, at least 0.01 mg/kg/day, at least 0.025 mg/kg/day, at least
0.05 mg/kg/day, at least 0.075 mg/kg/day, at least 0.1 mg/kg/day, at least 0.25 mg/kg/day,
at least 0.5 mg/kg/day, at least 0.75 mg/kg/day, at least 1.0 mg/kg/day, at least
2.5 mg/kg/day, at least 5.0 mg/kg/day, at least 7.5 mg/kg/day, or at least 10 mg/kg/day.
In yet other aspects of this embodiment, in conjunction with a methylxanthine, an
effective amount of a terpene disclosed herein may be,
e.g., about 0.001 mg/kg/day to about 0.1 mg/kg/day, about 0.001 mg/kg/day to about 0.5
mg/kg/day, about 0.001 mg/kg/day to about 1 mg/kg/day, about 0.001 mg/kg/day to about
5 mg/kg/day, about 0.001 mg/kg/day to about 10 mg/kg/day, about 0.01 mg/kg/day to
about 0.1 mg/kg/day, about 0.01 mg/kg/day to about 0.5 mg/kg/day, about 0.01 mg/kg/day
to about 1 mg/kg/day, about 0.01 mg/kg/day to about 5 mg/kg/day, about 0.01 mg/kg/day
to about 10 mg/kg/day, about 0.1 mg/kg/day to about 0.1 mg/kg/day, about 0.1 mg/kg/day
to about 0.5 mg/kg/day, about 0.1 mg/kg/day to about 1 mg/kg/day, about 0.1 mg/kg/day
to about 5 mg/kg/day, or about 0.1 mg/kg/day to about 10 mg/kg/day.
[0109] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of a terpene disclosed herein generally is in the range of about
0.1 mg/day to about 500 mg/day. In other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of a terpene disclosed herein may be,
e.g., at least 0.1 mg/day, at least 0.5 mg/day, at least 1 mg/day, at least 5 mg/day,
at least 10 mg/day, at least 20 mg/day, at least 30 mg/day, at least 40 mg/day, at
least 50 mg/day, at least 60 mg/day, at least 70 mg/day, at least 80 mg/day, at least
90 mg/day, at least 100 mg/day, at least 150 mg/day, at least 200 mg/day, at least
250 mg/day, at least 300 mg/day, at least 350 mg/day, at least 400 mg/day, at least
450 mg/day, or at least 500 mg/day. In yet other aspects of this embodiment, in conjunction
with a methylxanthine, an effective amount of a terpene disclosed herein may be,
e.g., about 0.1 mg/day to about 10 mg/day, about 0.1 mg/day to about 20 mg/day, about
0.1 mg/day to about 40 mg/day, about 0.1 mg/day to about 60 mg/day, about 0.1 mg/day
to about 80 mg/day, about 0.1 mg/day to about 100 mg/day, about 1 mg/day to about
10 mg/day, about 1 mg/day to about 20 mg/day, about 1 mg/day to about 40 mg/day, about
1 mg/day to about 60 mg/day, about 1 mg/day to about 80 mg/day, about 1 mg/day to
about 100 mg/day, about 1 mg/day to about 150 mg/day, about 1 mg/day to about 200
mg/day, about 1 mg/day to about 250 mg/day, about 1 mg/day to about 300 mg/day, about
1 mg/day to about 350 mg/day, about 1 mg/day to about 400 mg/day, about 1 mg/day to
about 450 mg/day, about 1 mg/day to about 500 mg/day, about 2.5 mg/day to about 10
mg/day, about 2.5 mg/day to about 20 mg/day, about 2.5 mg/day to about 40 mg/day,
about 2.5 mg/day to about 60 mg/day, about 2.5 mg/day to about 80 mg/day, about 2.5
mg/day to about 100 mg/day. about 2.5 mg/day to about 100 mg/day, about 2.5 mg/day
to about 150 mg/day, about 2.5 mg/day to about 200 mg/day, about 2.5 mg/day to about
250 mg/day, about 2.5 mg/day to about 300 mg/day, about 2.5 mg/day to about 350 mg/day,
about 2.5 mg/day to about 400 mg/day, about 2.5 mg/day to about 450 mg/day, about
2.5 mg/day to about 500 mg/day, about 10 mg/day to about 100 mg/day, about 10 mg/day
to about 150 mg/day, about 10 mg/day to about 200 mg/day, about 10 mg/day to about
250 mg/day, about 10 mg/day to about 300 mg/day, about 10 mg/day to about 350 mg/day,
about 10 mg/day to about 400 mg/day, about 10 mg/day to about 450 mg/day, or about
10 mg/day to about 500 mg/day.
[0110] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of an ACE inhibitor and/or an angiotensin II receptor antagonist
disclosed herein generally is in the range of about 0.01 mg/kg/day to about 10 mg/kg/day.
In other aspects of this embodiment, in conjunction with a methylxanthine, an effective
amount of an ACE inhibitor and/or an angiotensin II receptor antagonist disclosed
herein may be,
e.g., at least 0.01 mg/kg/day, at least 0.025 mg/kg/day, at least 0.05 mg/kg/day, at
least 0.075 mg/kg/day, at least 0.1 mg/kg/day, at least 0.25 mg/kg/day, at least 0.5
mg/kg/day, at least 0.75 mg/kg/day, at least 1.0 mg/kg/day, at least 2.5 mg/kg/day,
at least 5.0 mg/kg/day, at least 7.5 mg/kg/day, or at least 10 mg/kg/day. In yet other
aspects of this embodiment, in conjunction with a methylxanthine, an effective amount
of an ACE inhibitor and/or an angiotensin II receptor antagonist disclosed herein
may be,
e.g., about 0.01 mg/kg/day to about 0.1 mg/kg/day, about 0.01 mg/kg/day to about 0.5
mg/kg/day, about 0.01 mg/kg/day to about 1 mg/kg/day, about 0.01 mg/kg/day to about
5 mg/kg/day, about 0.01 mg/kg/day to about 10 mg/kg/day, about 0.1 mg/kg/day to about
0.1 mg/kg/day, about 0.1 mg/kg/day to about 0.5 mg/kg/day, about 0.1 mg/kg/day to
about 1 mg/kg/day, about 0.1 mg/kg/day to about 5 mg/kg/day, or about 0.1 mg/kg/day
to about 10 mg/kg/day.
[0111] In aspects of this embodiment, in conjunction with a methylxanthine, a therapeutically
effective amount of an ACE inhibitor and/or an angiotensin II receptor antagonist
disclosed herein generally is in the range of about 1 mg/day to about 500 mg/day.
In other aspects of this embodiment, in conjunction with a methylxanthine, an effective
amount of an ACE inhibitor and/or an angiotensin II receptor antagonist disclosed
herein may be,
e.g., at least 1 mg/day, at least 5 mg/day, at least 10 mg/day, at least 25 mg/day, at
least 50 mg/day, at least 75 mg/day, at least 100 mg/day, at least 150 mg/day, at
least 200 mg/day, at least 250 mg/day, at least 300 mg/day, at least 350 mg/day, at
least 400 mg/day, at least 450 mg/day, or at least 500 mg/day. In yet other aspects
of this embodiment, in conjunction with a methylxanthine, an effective amount of an
ACE inhibitor and/or an angiotensin II receptor antagonist disclosed herein may be,
e.g., about 1 mg/day to about 100 mg/day, about 1 mg/day to about 150 mg/day, about 1
mg/day to about 200 mg/day, about 1 mg/day to about 250 mg/day, about 1 mg/day to
about 300 mg/day, about 1 mg/day to about 350 mg/day, about 1 mg/day to about 400
mg/day, about 1 mg/day to about 450 mg/day, about 1 mg/day to about 500 mg/day, about
10 mg/day to about 100 mg/day, about 10 mg/day to about 150 mg/day, about 10 mg/day
to about 200 mg/day, about 10 mg/day to about 250 mg/day, about 10 mg/day to about
300 mg/day, about 10 mg/day to about 350 mg/day, about 10 mg/day to about 400 mg/day,
about 10 mg/day to about 450 mg/day, or about 10 mg/day to about 500 mg/day.
[0112] Dosing can be single dosage or cumulative (serial dosing), and can be readily determined
by one skilled in the art. For instance, treatment of a coughing condition may comprise
a one-time administration of an effective dose of a pharmaceutical composition disclosed
herein. Alternatively, treatment of a coughing condition may comprise multiple administrations
of an effective dose of a pharmaceutical composition carried out over a range of time
periods, such as,
e.g., once daily, twice daily, trice daily, once every few days, or once weekly. The
timing of administration can vary from individual to individual, depending upon such
factors as the severity of an individual's symptoms. For example, an effective dose
of a pharmaceutical composition disclosed herein can be administered to an individual
once daily for an indefinite period of time, or until the individual no longer requires
therapy. A person of ordinary skill in the art will recognize that the condition of
the individual can be monitored throughout the course of treatment and that the effective
amount of a pharmaceutical composition disclosed herein that is administered can be
adjusted accordingly.
[0113] Various routes of administration can be useful for administering a therapeutic compound
disclosed herein, according to a method of treating a coughing condition disclosed
herein. A pharmaceutical composition may be administered to an individual by any of
a variety of means depending,
e.g., on the type of coughing condition to be treated, the location of coughing condition
to be treated, the specific therapeutic compound or composition used, or other compound
to be included in the composition, and the history, risk factors and symptoms of the
individual. As such, topical, enteral or parenteral routes of administration may be
suitable for of treating a coughing condition disclosed herein and such routes include
both local and systemic delivery of a therapeutic compound or composition disclosed
herein. Compositions comprising either a single therapeutic compound disclosed herein,
or two or more therapeutic compounds disclosed herein are intended for inhaled, topical,
intranasal, sublingual, intravenous, rectal and/or vaginal use may be prepared according
to any method known to the art for the manufacture of pharmaceutical compositions.
[0114] A pharmaceutical composition disclosed herein can be administered to an individual
in a single formulation or in separate formulations, for combined, simultaneous or
sequential administration. In one embodiment, an individual is administered a first
composition comprising a methylxanthine and a second composition comprising another
therapeutic compound having antitussive activity. In aspects of this embodiment, an
individual is administered a first composition comprising at least one methylxanthine
and a second composition comprising at least one other therapeutic compound having
antitussive activity. In aspects of this embodiment, the at least one other therapeutic
compound having antitussive activity includes, without limitation, a non-opiate antitussive,
an opiate antitussive, a decongestant, an expectorant, a mucolytic agent, an anti-histamine,
a non-steroidal anti-inflammatory drug (NSAID), a neuropathic pain agent, a terpene,
an ace inhibitor, and/or an angiotensin II receptor antagonist.
[0115] In another embodiment, an individual is administered a composition comprising a methylxanthine
and another therapeutic compound having antitussive activity. In aspects of this embodiment,
an individual is administered a composition comprising at least one methylxanthine
and at least one other therapeutic compound having antitussive activity. In aspects
of this embodiment, the at least one other therapeutic compound having antitussive
activity includes, without limitation, a non-opiate antitussive, an opiate antitussive,
a decongestant, an expectorant, a mucolytic agent, an anti-histamine, a non-steroidal
anti-inflammatory drug (NSAID), a neuropathic pain agent, a terpene, an ace inhibitor,
and/or an angiotensin II receptor antagonist.
[0116] A pharmaceutical composition disclosed herein can also be administered to an individual
in combination with other therapeutic compounds to increase the overall therapeutic
effect of the treatment. The use of multiple compounds to treat an indication can
increase the beneficial effects while reducing the presence of side effects.
[0117] In an aspect of this embodiment, β
2-agonists, such as, e.g. salbutamol, salmeterol and formoterol, may be formulated
for co-administration with a therapeutic compound or composition disclosed herein.
In another aspect of this embodiment, anti-muscarinic compounds, such as,
e.g., ipratropium (e.g. ipratropium bromide) or tiotropium may be formulated for co-administration
with a therapeutic compound or composition disclosed herein. In yet another aspect
of this embodiment, steroids, such as,
e.g., beclomethasone, dipropionate and fluticasone may be formulated for co-administration
with a therapeutic compound or composition disclosed herein. In still another aspect
of this embodiment, matrix metalloproteinase inhibitors, leukotrienes, antibiotics,
anti-infective agents, antineoplastics, peptides, antitussives, nicotine, PDE4 inhibitors,
elastase inhibitors and/or sodium cromoglycate may be formulated for co-administration
with a therapeutic compound or composition disclosed herein.
[0118] Aspects of the present specification may also be described as follows:
- 1. A composition comprising a methylxanthine and a plurality of additional therapeutic
agent having antitusive activity.
- 2. The composition according to embodiment 1, wherein the methylxanthine includes
Aminophylline, Caffeine, IBMX, Paraxanthine, Pentoxifylline, Theobromine, Theophylline,
Xanthine, or any combination thereof.
- 3. The composition according to embodiment 1 or 2, wherein the plurality of therapeutic
agent having antitusive activity includes a non-opiate antitussive agent, an opiate
antitussive agent, a decongestant, an expectorant, a mucolytic agent, an anti-histamine,
a non-steroidal anti-inflammatory drug (NSAID), a neuropathic pain agent, a terpene,
an ACE inhibitor, an angiotensin II receptor antagonist or any combination thereof.
- 4. The composition according to embodiment 3, wherein the non-opiate antitussive agent
includes Benproperine, Benzonate, Bibenzonium, Butamirate, Cloperastine, Clofedanol,
Dextromethorphan, Dibunate, Dimemorfan, Dropropizine, Fedrilate, Indantadol, Isoaminile,
Morclofone, Meprotixol, Nepinalone, Oxolamine, Oxeladin, Piperidione, Pentoxyverine,
Prenoxdiazine, Zipeprol. or any combination thereof.
- 5. The composition according to embodiment 3, wherein the opiate antitussive agent
includes Alfentanil, Alphamethylfentanyl, Buprenorphine, Carfentanyl, Codeine, Diamorphine,
Dihydrocodeine, Ethyl Morphine, Etorphine, Fentanyl, Hydrocodone, Hydromorphone, Loperamide,
Morphine, Noscapine, Oripavine, Oxymorphone, Oxycodone, Papaverine, Pentazocine, Pethidine,
Propoxyphene, Remifentanil, Sufentanil, Thebaine, Tipepidine, Tramadol, or any combination
thereof.
- 6. The composition according to embodiment 3, wherein the decongestant includes Ephedrine,
Levmetamfetamine, Naphazoline, Oxymetazoline, Phenylephrine, Phenylpropanolamine,
Propylhexedrine, Pseudoephedrine, Synephrine, Tetrahydrozoline, or any combination
thereof.
- 7. The composition according to embodiment 3, wherein the expectorant includes Ambroxol,
Ammonium Bicarbonate, Ammonium Carbonate, Bromhexine, Calcium Iodide, Carbocysteine,
Guaiacol, Guaicacol Benzoate, Guaiacol Carbonate, Guaiacol Phosphate, Guaifenesin,
Guaithylline, Hydriodic Acid, Iodinated Glycerol, Potassium Guaiacolsulfonate, Potassium
Iodide, Sodium Citrate, Sodium Iodide, Storax Terebene, Terpin, Trifolium, Althea
Root, Antimony Pentasulfide, Creosote, Ipecacuanha (Syrup of Ipecac), Levoverbenone,
Senega, Tyloxapol, or any combination thereof.
- 8. The composition according to embodiment 3, wherein the mucolytic agent includes
Acetylcysteine, Bromhexine, Carbocysteine, Domiodol, Erdostine, Letostine, Lysozyme,
Mecysteine Hydrochloride, Mesna, Sobrerol, Stepronin, Tiopronin, Tyloxapol, Ambroxol,
Ammonium Chloride, Dornase Alfa, Eprazinone, Erdosteine, Letosteine, Neltenexine,
or any combination thereof.
- 9. The composition according to embodiment 3, wherein the anti-histamine includes
Acrivastine, Alimemazine, Astemizole, Azatadine, Bromodiphenhydramine, Brompheniramine,
Carbinoxamine, Cetirizine, Chlorpheniramine, Clemastine, Cyproheptadine, Desloratadine,
Dexchlorpheniramine, Dextrobrompheniramine, Dimenhydrinate, Diphenhydramine, Doxylamine,
Fexofenadine, Hydroxyzine, Levocetirizine, Loratadine, Meclizine, Mizolastine, Quetiapine,
Pheniramine, Promethazine, Pyrilamine, Tripelennamine, Triprolidine., or any combination
thereof.
- 10. The composition according to embodiment 3, wherein the NSAID includes a salicylate
derivative NSAID, a p-amino phenol derivative NSAID, a propionic acid derivative NSAID,
an acetic acid derivative NSAID, an enolic acid derivative NSAID, a fenamic acid derivative
NSAID, a non-selective cyclo-oxygenase (COX) inhibitor, a selective cyclooxygenase
1 (COX 1) inhibitor, a selective cyclooxygenase 2 (COX 2) inhibitor, or any combination
thereof.
- 11. The composition according to embodiment 3, wherein the neuropathic pain agent
includes Acetazolamide, Amitriptyline, Amitriptylinoxide, Baclofen, Butriptyline,
Carbamazepine, Carisoprodol, Clobazam, Clomipramine, Conotoxins, Cyclobenzaprine,
Demexiptiline, Desipramine, Diazepam, Dibenzepin, Dimetacrine, Doxepin, Duloexetine,
Ethotoin, Felbamate, Fosphenytoin, Gabapentin, Imipramine, Imipraminoxide, Ketamine,
Lamotrigine, Lidocaine, Lignocaine, Lofepramine, Mephenytoin, Melitracen, Metapramine,
Metaxalone, Methadone, Methocarbamol, Nitroxazepine, Nortriptyline, Noxiptiline, Oxcarbazepine,
Phenobarbital, Phensuximide, Phenytoin, Pipofezine, Pregabalin, Progabide, Propizepine,
Protriptyline, Quinupramine, Stiripentol, Tiagabine, Topiramate, Trimethadione, Valproate,
Venlafaxine, Vigabatrin, Zonisamide, or any combination thereof.
- 12. The composition according to embodiment 3, wherein the terpene includes camphor
oil, citronella, clove oil, eucalyptus oil, ginger oil, horsemint oil, I-menthol,
lemon oil, limonene, marjoram oil, mint oil, neroli oil, peppermint oil, pine oil,
rose oil, rosemary oil, spearmint oil, tea tree oil, thyme oil, water mint oil, or
any combination thereof.
- 13. The composition according to embodiment 3, wherein the ACE inhibitor includes
Captopril, Enalapril, Lisinopril, Meleate, Ramipril, or any combination thereof.
- 14. The composition according to embodiment 3, wherein the angiotensin II receptor
antagonist includes Azilsartan, Candesartan, Eprosartan, Irbesartan, Losartan, Olmesartan,
Telmisartan, Valsartan, or any combination thereof.
- 15. The composition according to embodiments 1-3, wherein the plurality of therapeutic
compounds does not include a non-opiate antitussive agent.
- 16. The composition according to embodiments 1-4, wherein the plurality of therapeutic
compounds does not include Dextromethorphan.
- 17. The composition according to embodiments 1-3, wherein the plurality of therapeutic
compounds does not include an anti-histamine.
- 18. The composition according to embodiments 1-3 or 9, wherein the plurality of therapeutic
compounds does not include Azatadine, Bromodiphenhydramine, Brompheniramine, Carbinoxamine,
Cetirizine, Chlorpheniramine, Clemestine, Dexchlorpheniramine, Dexbrompheniramine,
Diphenhydramine, Doxylamine, Pyrilamine, Tripelennamine, or Tripolidine.
- 19. The composition according to embodiments 1-18, wherein the pharmaceutical composition
reduces an unwanted side.
- 20. The composition according to embodiment 19, wherein the unwanted side includes
sedation, cognitive fogging, dizziness, drowsiness, postural hypertension, coordination
problems, weakness, tremors, respiratory depression, psychotropic effects, sleep disturbances,
unwanted waitfulness, CNS stimulation, weight gain, appetite change, change in sexual
function, constipation, dry mouth, gut erosion, gastric ulcerations, renal inflammation,
cardiovascular hypertension, cardiovascular stimulation, hyperchlimina, not going
into public, chest pain, stress incontinence, or any combination thereof.
- 21. The composition according to embodiments 1-20, wherein the antitussive activity
reduces a symptom associated with a coughing condition.
- 22. The composition according to embodiment 21, wherein the antitussive activity reduces
a symptom associated with a coughing condition by at least 10%, at least 15%, at least
20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least
50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least
80%, at least 85%, at least 90%, or at least 95%.
- 23. The composition according to embodiment 21, wherein the symptom includes the frequency
of a cough, the severity of a cough, the volume or noise level of a cough, hoarseness,
sore throat, breathing difficulty, respiratory congestion, wheezing, respiratory constriction,
respiratory inflammation, muscle spasms associated with a cough, phlegm production,
fainting, insomnia, vomiting, subconjunctival hemorrhage (red eye), cough defecation,
cough urination, abdominal hernia, pelvic hernia, costochondritis, or lower rib fracture.
- 24. The composition according to embodiments 1-23, wherein the antitussive activity
suppresses a vagal nerve function associated with a cough.
- 25. The composition according to embodiment 24, wherein the antitussive activity suppresses
a vagal nerve function associated with a cough by at least 10%, at least 15%, at least
20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least
50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least
80%, at least 85%, at least 90%, or at least 95%.
- 26. The composition according to embodiments 1-25, wherein the antitussive activity
suppresses a central nerve function associated with a cough.
- 27. The composition according to embodiment 26, wherein the antitussive activity suppresses
a central nerve function associated with a cough by at least 10%, at least 15%, at
least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at
least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at
least 80%, at least 85%, at least 90%, or at least 95%.
- 28. The composition according to embodiments 1-27, wherein the antitussive activity
suppresses a peripheral nerve function associated with a cough.
- 29. The composition according to embodiment 28, wherein the antitussive activity suppresses
a peripheral nerve function associated with a cough by at least 10%, at least 15%,
at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%,
at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%,
at least 80%, at least 85%, at least 90%, or at least 95%.
- 30. The composition according to embodiments 1-29, wherein the composition is formulated
for inhalatory administration.
- 31. The composition according to embodiments 1-29, wherein the composition is formulated
for oral administration.
- 32. The composition according to embodiments 1-3 or 17-31, wherein the composition
includes a methylxanthine and a non-opiate antitussive agent.
- 33. The composition according to embodiment 32, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 1 mg to about 250 mg of the
non-opiate antitussive agent.
- 34. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and an opiate antitussive agent.
- 35. The composition according to embodiment 34, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 0.1 mg to about 75 mg of the
opiate antitussive agent.
- 36. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and a decongestant.
- 37. The composition according to embodiment 36, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 1 mg to about 6000 mg of the
decongestant.
- 38. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and an expectorant.
- 39. The composition according to embodiment 38, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 1 mg to about 6000 mg of the
expectorant.
- 40. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and a mucolytic agent.
- 41. The composition according to embodiment 40, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 1 mg to about 6000 mg of the
mucolytic agent.
- 42. The composition according to embodiments 1-3, 15, 16, or 19-31, wherein the composition
includes a methylxanthine and an anti-histamine.
- 43. The composition according to embodiment 42, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 0.1 mg to about 100 mg of the
anti-histamine.
- 44. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and a NSAID.
- 45. The composition according to embodiment 44, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 1 mg to about 3200 mg of the
NSAID.
- 46. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and a neuropathic pain agent.
- 47. The composition according to embodiment 46, wherein the composition includes about
1 mg to about 1000 mg of the methylxanthine and about 0.1 mg to about 8000 mg of the
neuropathic pain agent.
- 48. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and a terpene.
- 49. The composition according to embodiments 48, wherein the composition includes
about 1 mg to about 1000 mg of the methylxanthine and about 0.01 mg to about 200 mg
of the terpene.
- 50. The composition according to embodiments 1-3 or 15-31, wherein the composition
includes a methylxanthine and an ACE inhibitor.
- 51. The composition according to embodiment 50, wherein the composition includes about
1 mg to a bout 1000 mg of the methylxanthine and about 0.1 mg to about 450 mg of the
ACE inhibitor.
- 52. The composition of Claim 1, wherein the composition includes a methylxanthine
and an angiotensin II receptor antagonist.
- 53. The composition of Claim 46, wherein the composition includes about 1 mg to about
1000 mg of the methylxanthine and about 0.1 mg to about 450 mg of the angiotensin
II receptor antagonist.
- 54. A method of treating a coughing condition in an individual, the method comprising
the step of administering a composition according to embodiments 1-53, wherein administration
reduces a symptom associated with the coughing condition.
- 55. The method according to embodiment 54, wherein the coughing condition comprises
an acute coughing condition.
- 56. The method according to embodiment 54, wherein the coughing condition comprises
a subacute coughing condition.
- 57. The method according to embodiment 54, wherein the coughing condition comprises
a chronic coughing condition.
- 58. The method according to embodiments 54-57, wherein the coughing condition comprises
a non-productive coughing condition.
- 59. The method according to embodiments 54-57, wherein the coughing condition comprises
a productive coughing condition.
- 60. The method according to embodiments 54-59, wherein the coughing condition comprises
a cough associated with a disease or disorder.
- 61. The method according to embodiment 60, wherein the disease or disorder is an asthma,
an atopic cough a bronchitis, a gastroesophageal reflux disease (GERD), an infection
of the respiratory tract, an inflammation, a medication, a pollutant, a post-nasal
drip, a smoking event, a vagal nerve irritation, a diseases of the external auditory
canal, a lung disease, a lung tumor, a habit cough, a tic, a Tourette syndrome, a
cardiovascular disease, or a post-infectious cough.
- 62. The method according to embodiment 61, wherein the lung disease includes a bronchiectasis,
a cystic fibrosis, an interstitial lung disease, a sarcoidosis, or a COPD.
- 63. The method according to embodiment 61, wherein the cardiovascular disease includes
a heart failure, a pulmonary infarction, or an aortic aneurysm.
- 64. The method according to embodiment 61, wherein the infection of the respiratory
tract includes a cold, croup, pertussis, pneumonia, or tuberculosis.
- 65. The method according to embodiments 54-64, wherein administration of the pharmaceutical
composition reduces an unwanted side.
- 66. The method according to embodiment 65, wherein the unwanted side includes sedation,
cognitive fogging, dizziness, drowsiness, postural hypertension, coordination problems,
weakness, tremors, respiratory depression, psychotropic effects, sleep disturbances,
unwanted waitfulness, CNS stimulation, weight gain, appetite change, change in sexual
function, constipation, dry mouth, gut erosion, gastric ulcerations, renal inflammation,
cardiovascular hypertension, cardiovascular stimulation, hyperchlimina, not going
into public, chest pain, stress incontinence, or any combination thereof.
- 67. The method according to embodiments 54-66, wherein the symptom includes coughing,
hoarseness, sore throat, breathing difficulty, respiratory congestion, wheezing, respiratory
constriction, respiratory inflammation, muscle spasms associated with a cough, phlegm
production, fainting, insomnia, vomiting, subconjunctival hemorrhage (red eye), cough
defecation, cough urination, abdominal hernia, pelvic hernia, costochondritis, lower
rib fracture, or any combination thereof.
- 68. Use of a composition according to embodiments 1-53 in the manufacture of a medicament
for the treatment of a coughing condition.
- 69. Use of a composition according to embodiments 1-53 in the treatment of a coughing
condition.
- 70. The use according to embodiment 67 or 68, wherein the coughing condition comprises
an acute coughing condition.
- 71. The use according to embodiment 67 or 68, wherein the coughing condition comprises
a subacute coughing condition.
- 72. The use according to embodiment 67 or 68, wherein the coughing condition comprises
a chronic coughing condition.
- 73. The use according to embodiments 67-72, wherein the coughing condition comprises
a non-productive coughing condition.
- 74. The use according to embodiments 67-72, wherein the coughing condition comprises
a productive coughing condition.
- 75. The use according to embodiments 67-74, wherein the coughing condition comprises
a cough associated with a disease or disorder.
- 76. The use according to embodiment 75, wherein the disease or disorder is an asthma,
an atopic cough a bronchitis, a gastroesophageal reflux disease (GERD), an infection
of the respiratory tract, an inflammation, a medication, a pollutant, a post-nasal
drip, a smoking event, a vagal nerve irritation, a diseases of the external auditory
canal, a lung disease, a lung tumor, a habit cough, a tic, a Tourette syndrome, a
cardiovascular disease, or a post-infectious cough.
- 77. The use according to embodiment 76, wherein the lung disease includes a bronchiectasis,
a cystic fibrosis, an interstitial lung disease, a sarcoidosis, or a COPD.
- 78. The use according to embodiment 76, wherein the cardiovascular disease includes
a heart failure, a pulmonary infarction, or an aortic aneurysm.
- 79. The use according to embodiment 76, wherein the infection of the respiratory tract
includes a cold, croup, pertussis, pneumonia, or tuberculosis.
- 80. The use according to embodiments 67-79, wherein administration of the pharmaceutical
composition reduces an unwanted side.
- 81. The use according to embodiment 80, wherein the unwanted side includes sedation,
cognitive fogging, dizziness, drowsiness, postural hypertension, coordination problems,
weakness, tremors, respiratory depression, psychotropic effects, sleep disturbances,
unwanted waitfulness, CNS stimulation, weight gain, appetite change, change in sexual
function, constipation, dry mouth, gut erosion, gastric ulcerations, renal inflammation,
cardiovascular hypertension, cardiovascular stimulation, hyperchlimina, not going
into public, chest pain, stress incontinence, or any combination thereof.
- 82. The use according to embodiment 80, wherein the symptom includes coughing, hoarseness,
sore throat, breathing difficulty, respiratory congestion, wheezing, respiratory constriction,
respiratory inflammation, muscle spasms associated with a cough, phlegm production,
fainting, insomnia, vomiting, subconjunctival hemorrhage (red eye), cough defecation,
cough urination, abdominal hernia, pelvic hernia, costochondritis, lower rib fracture,
or any combination thereof.
EXAMPLES
[0119] The following non-limiting examples are provided for illustrative purposes only in
order to facilitate a more complete understanding of representative embodiments now
contemplated. These examples should not be construed to limit any of the embodiments
described in the present specification, including those pertaining to the compounds,
pharmaceutical compositions, or methods or uses of treating a coughing condition.
Example 1
Oral Administration of Theobromine
[0120] This example illustrates the antitussive activity of theobromine.
[0121] Nine male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) were
randomly allocated equally into one of three groups. Group 1 animals were administered
vehicle only; Group 2 animals were orally dosed (volume 2 mL/kg) with 3 mg/kg of theobromine;
Group 3 animals were orally dosed with 7 mg/kg of theobromine. All pre-treatments
were administered 120 minutes prior to citric acid exposure. Individual guinea pigs
were placed in an exposure chamber with an airflow of 2 L/min for 10 minutes prior
to citric acid exposure to allow acclimatisation. Cough responses were induced by
exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser at a nebulisation
rate of 0.6 mL/min for 10 minutes. Coughs were counted throughout the 10 minute citric
acid exposure and for a further 5 minute post-exposure recovery period.
[0122] The results of this study are shown in Table 1. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 28 ± 3 coughs with
a mean onset time for first cough of 66 ± 18 seconds. In theobromine-treated animals
there was a dose dependant decrease in the total number of coughs evoked by citric
acid exposure as well as an increase in the onset time to the first cough. At the
highest dose, the total number of coughs had been reduced to 18 ± 3, while the onset
to the first cough had been extended to 98 ± 36 seconds.
| Table 1. Cough Suppression of Theobromine |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
28 ± 3 |
66 ± 18 sec |
| Group 2 |
3 mg/kg theobromine (p.o.) |
25 ± 4 |
73 ± 17 sec |
| Group 3 |
7 mg/kg theobromine (p.o.) |
18 ± 3 |
98 ± 36 sec |
| 1n = 3 guinea pigs per group. |
Example 2
Oral and Intratracheal Administration of Theobromine
[0123] This example illustrates the antitussive activity of theobromine.
[0124] Thirty-six male Dunkin Hartley guinea pigs (350-550 g, supplied by Harlan UK Ltd)
were randomly allocated equally into one of six groups. Group 1 animals were administered
vehicle only; Group 2 animals were intra-peronteneally dosed (volume 2 mL/kg) with
25 mg/kg of codeine; Group 3 animals were orally dosed (volume 2 mL/kg) with 30 mg/kg
of theobromine; Group 4 animals were intra-tracheally dosed with 3 mg/kg of theobromine;
Group 5 animals were intra-tracheally dosed with 10 mg/kg of theobromine; and Group
6 animals were intra-tracheally dosed with 30 mg/kg of theobromine. All pre-treatments
were administered 30 minutes prior to citric acid exposure. Individual guinea pigs
were placed in an exposure chamber with an airflow of 2 Umin for 10 minutes prior
to citric acid exposure to allow acclimatisation. Cough responses were induced by
exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser at a nebulisation
rate of 0.6 mL/min for 10 minutes. Coughs were counted throughout the 10 minute citric
acid exposure and for a further 5 minute post-exposure recovery period.
[0125] The results of this study are shown in Table 2. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 26 ± 4 coughs with
a mean onset time for first cough of 71 ± 26 seconds. The level of response was significantly
reduced to 5 ± 1 coughs in codeine-treated animals and the onset to the first cough
was significantly extended to 337 ± 51 seconds. Pretreatment with theobromine (30
mg/kg, p.o.) also caused a significant reduction to the number of citric acid induced
coughs (12 ± 2), although the onset of the first cough was not significantly increased
when compared to the control animals (126 ± 20 seconds c.f. 71 ± 26 seconds). Local
administration (i.t.) of theobromine also had a significant dose dependant effect
on the total number of coughs, reducing the number of coughs at a dose of 30 mg/kg
of theobromine to 6 ± 1. Indeed at the doses of 10 mg/kg (i.t.) theobromine caused
a similar degree of cough suppression to that observed at 30 mg/kg (p.o.) theobromine
(10.3 ± 2 c.f. 12 ± 2). It was also evident with increasing concentration of intra-tracheally
administered theobromine, that there was an increase to the onset of the first cough
which was significantly increased with a dose of 30 mg/kg to 210 ± 22 seconds.
| Table 2. Cough Suppression of Theobromine |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
26 ± 4 |
71 ± 26 sec |
| Group 2 |
25 mg/kg codeine (i.p.) |
5 ± 1** |
337 ± 51 sec |
| Group 3 |
30 mg/kg theobromine (p.o.) |
12 ± 2** |
126 ± 20 sec |
| Group 4 |
3 mg/kg theobromine (i.t.) |
17 ± 2* |
115 ± 29 sec |
| Group 5 |
10 mg/kg theobromine (i.t.) |
10 ± 2** |
134 ± 18 sec |
| Group 6 |
30 mg/kg theobromine (i.t.) |
6 ± 1** |
210 ± 22 sec* |
| 1n = 6 guinea pigs per group. |
| **P<0.01. |
| *P<0.05. |
Example 3
Theobromine and a Non-Opiate Antitussive Agent
[0126] This example illustrates the antitussive activity of theobromine in combination with
a non-opiate antitussive agent.
[0127] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) were
randomly allocated equally into one of five groups. Group 1 animals were administered
vehicle only; Group 2 animals were intra-peronteneally dosed (volume 2 mL/kg) with
25 mg/kg of codeine; Group 3 animals were orally dosed (volume 2 mL/kg) with 10 mg/kg
of theobromine; Group 4 animals were orally dosed with 10 mg/kg of theobromine and
10 mg/kg dextromethophan; and Group 5 animals were orally dosed with 10 mg/kg of theobromine
and 30 mg/kg dextromethophan. Pre-treatments with theobromine were administered 120
minutes prior to citric acid exposure, whereas pre-treatments with dextromethophan
or vehicle were administered 60 minutes prior to citric acid exposure. Pre-treatments
with codeine were administered 30 minutes prior to citric acid exposure. Individual
guinea pigs were placed in an exposure chamber with an airflow of 2 L/min for 10 minutes
prior to citric acid exposure to allow acclimatisation. Cough responses were induced
by exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser at a nebulisation
rate of 0.6 mL/min for 10 minutes. Coughs were counted throughout the 10 minute citric
acid exposure and for a further 5 minute post-exposure recovery period.
[0128] The results of this study are shown in Table 3. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 28 ± 5 coughs with
a mean onset time for first cough of 52 ± 9 seconds. The level of response was significantly
reduced to 7 ± 2 coughs in codeine-treated animals and the onset to the first cough
was significantly extended to 170 ± 32 seconds. Pretreatment with theobromine (10
mg/kg) also caused a significant reduction to the number of citric acid induced coughs
(13 ± 2), as well as an increase duration to the onset of the first cough (139 ± 22
seconds). In combination with dextromethophan (10 mg/kg or 30 mg/kg), the inhibitory
effect of theobromine on the citric acid-induced tussive activity was potentiated
slightly with the higher dose both in respect to the total number of coughs (11 ±
2 c.f. 13 ± 2) and the onset time to the first cough (146 ± 23 seconds c.f. 139 ±
22 seconds).
| Table 3. Cough Suppression of Theobromine and Non-Opiate Antitussive Agent |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
28 ± 5 |
52 ± 9 sec |
| Group 2 |
25 mg/kg codeine (i.p.) |
7 ± 2** |
170 ± 32 sec** |
| Group 3 |
10 mg/kg theobromine (p.o.) |
13 ± 2** |
139 ± 22 sec* |
| Group 4 |
10 mg/kg theobromine (p.o.) 10 mg/kg dextromethophan (p.o.) |
15 ± 3* |
115 ± 14 sec |
| Group 5 |
10 mg/kg theobromine (p.o.) 30 mg/kg dextromethophan (p.o.) |
11 ± 2** |
146 ± 23 sec* |
| 1 n = 6 guinea pigs per group. |
| ** P < 0.01. |
| * P < 0.05. |
Example 4
Theobromine and an Opiate Antitussive Agent
[0129] This example illustrates the antitussive activity of theobromine in combination with
an opiate antitussive agent.
[0130] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) were
randomly allocated equally into one of five groups. Group 1 animals were administered
vehicle only; Group 2 animals were intra-peronteneally dosed (volume 2 mL/kg) with
25 mg/kg of codeine; Group 3 animals were orally dosed (volume 2 mL/kg) with 7 mg/kg
of theobromine; Group 4 animals were orally dosed with 7 mg/kg of theobromine and
8 mg/kg codeine; and Group 5 animals were orally dosed with 7 mg/kg of theobromine
and 16 mg/kg codeine. Pre-treatments with theobromine were administered 120 minutes
prior to citric acid exposure, whereas oral pre-treatments with codeine were administered
60 minutes prior to citric acid exposure. Intraperitoneal pre-treatments with codeine
were administered 30 minutes prior to citric acid exposure. Vehicle animals were dosed
at both 120 minutes and 60 minutes prior to citric acid exposure. Individual guinea
pigs were placed in an exposure chamber with an airflow of 2 L/min for 10 minutes
prior to citric acid exposure to allow acclimatisation. Cough responses were induced
by exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser at a nebulisation
rate of 0.6 mL/min for 10 minutes. Coughs were counted throughout the 10 minute citric
acid exposure and for a further 5 minute post-exposure recovery period.
[0131] The results of this study are shown in Table 4. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 27 ± 4 coughs with
a mean onset time for first cough of 61 ± 9 seconds. The level of response was significantly
reduced to 6 ± 1 coughs in codeine- treated animals and the onset to the first cough
was significantly extended to 195 ± 33 seconds. Pretreatment with theobromine (7 mg/kg)
also caused a reduction to the number of citric acid induced coughs (19 ± 3), as well
as an increase in duration to the onset of the first cough (91 ± 13 seconds), although
when compared to vehicle control animals these changes were not significant. However,
once combined with codeine (8 mg/kg or 16 mg/kg), the inhibitory response of theobromine
on the citric acid induced tussive activity was dose dependently potentiated. Indeed
in combination with the highest dose of codeine (16 mg/kg) the total number of coughs
were now significantly reduced to 4 ± 1 (c.f 19 ± 3 seen in animals treated with theobromine
alone), and onset to the first cough was also significantly extended to 202± 30 seconds
(c.f. 91 ± 13 seconds).
| Table 4. Cough Suppression of Theobromine and Opiate Antitussive Agent |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
27 ± 4 |
61 ± 9 sec |
| Group 2 |
25 mg/kg codeine (i.p.) |
6 ± 1** |
195 ± 33 sec** |
| Group 3 |
7 mg/kg theobromine (p.o.) |
19 ± 3 |
91 ± 13 sec |
| Group 4 |
7 mg/kg theobromine (p.o.) 8 mg/kg codeine (p.o.) |
10 ± 2** |
147 ± 15 sec* |
| Group 5 |
7 mg/kg theobromine (p.o.) 16 mg/kg codeine (p.o.) |
4 ± 1** |
202 ± 30 sec** |
| 1 n = 6 guinea pigs per group. |
| ** P < 0.01. |
|
|
|
| * P < 0.05. |
|
|
|
Example 5
Theobromine and a Decongestant
[0132] This example illustrates the antitussive activity of theobromine in combination with
a decongestant.
[0133] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) were
randomly allocated equally into one of five groups. Group 1 animals were administered
vehicle only; Group 2 animals were intra-peronteneally dosed (volume 2 mL/kg) with
25 mg/kg of codeine; Group 3 animals were orally dosed (volume 2 mL/kg) with 10 mg/kg
of theobromine; Group 4 animals were orally dosed with 10 mg/kg of theobromine and
10 mg/kg pseudoephidrine; and Group 5 animals were orally dosed with 10 mg/kg of theobromine
and 30 mg/kg pseudoephidrine. Pre-treatments with theobromine were administered 120
minutes prior to citric acid exposure, whereas oral pre-treatments with pseudoephidrine
were administered 30 minutes prior to citric acid exposure. Intraperitoneal pre-treatments
with codeine were administered 30 minutes prior to citric acid exposure. Vehicle animals
were dosed at both 120 minutes and 30 minutes prior to citric acid exposure. Individual
guinea pigs were placed in an exposure chamber with an airflow of 2 L/min for 10 minutes
prior to citric acid exposure to allow acclimatisation. Cough responses were induced
by exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser at a nebulisation
rate of 0.6 mL/min for 10 minutes. Coughs were counted throughout the 10 minute citric
acid exposure and for a further 5 minute post-exposure recovery period.
[0134] The results of this study are shown in Table 5. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 28 ± 4 coughs with
a mean onset time for first cough of 72 ± 10 seconds. The level of response was significantly
reduced to 6 ± 1 coughs in codeine-treated animals and the onset to the first cough
was significantly extended to 195 ± 25 seconds. Pretreatment with theobromine (10
mg/kg) also caused a significant reduction to the number of citric acid induced coughs
(13 ± 3), as well as an increase in duration to the onset of the first cough (156
± 15 seconds). In combination with pseudoephedrine (10 mg/kg and 30 mg/kg), the inhibitory
response of BC1036 on the citric acid induced tussive activity, was potentiated slightly
with the highest dose both in respect of total number of coughs (9 ± 2 c.f. 13 ± 3)
and onset time to the first cough (170 ± 15 seconds c.f. 156 ± 15 seconds).
| Table 5. Cough Suppression of Theobromine and Decongestant |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
28 ± 4 |
72 ± 10 sec |
| Group 2 |
25 mg/kg codeine (i.p.) |
6 ± 1** |
195 ± 25 sec** |
| Group 3 |
10 mg/kg theobromine (p.o.) |
13 ± 3** |
156 ± 15 sec** |
| Group 4 |
10 mg/kg theobromine (p.o.) 10 mg/kg pseudoephidrine (p.o.) |
12 ± 3** |
164 ± 17 sec** |
| Group 5 |
10 mg/kg theobromine (p.o.) 30 mg/kg pseudoephidrine (p.o.) |
9 ± 2** |
170 ± 15 sec** |
| 1 n = 6 guinea pigs per group. |
| ** P < 0.01. |
Example 6
Theobromine and an Antihistamine
[0135] This example illustrates the antitussive activity of theobromine in combination with
an antihistamine.
[0136] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) were
randomly allocated equally into one of five groups. Group 1 animals were administered
vehicle only; Group 2 animals were intra-peronteneally dosed (volume 2 mL/kg) with
25 mg/kg of codeine; Group 3 animals were orally dosed (volume 2 mL/kg) with 10 mg/kg
of theobromine; Group 4 animals were orally dosed with 10 mg/kg of theobromine and
10 mg/kg chlorpheniramine; and Group 5 animals were orally dosed with 10 mg/kg of
theobromine and 30 mg/kg chlorpheniramine. Pre-treatments with theobromine were administered
120 minutes prior to citric acid exposure, whereas oral pre-treatments with chlorpheniramine
were administered 30 minutes prior to citric acid exposure. Intraperitoneal pre-treatments
with codeine were administered 30 minutes prior to citric acid exposure. Vehicle animals
were dosed at both 120 minutes and 30 minutes prior to citric acid exposure. Individual
guinea pigs were placed in an exposure chamber with an airflow of 2 L/min for 10 minutes
prior to citric acid exposure to allow acclimatisation. Cough responses were induced
by exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser at a nebulisation
rate of 0.6 mL/min for 10 minutes. Coughs were counted throughout the 10 minute citric
acid exposure and for a further 5 minute post-exposure recovery period.
[0137] The results of this study are shown in Table 6. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 26 ± 4 coughs with
a mean onset time for first cough of 42 ± 9 seconds. The level of response was significantly
reduced to 5 ± 1 coughs in codeine-treated animals and the onset to the first cough
was significantly extended to 236 ± 22 seconds. Pretreatment with theobromine (10
mg/kg) also caused a significant reduction to the number of citric acid induced coughs
(15 ± 2), as well as an increase in duration to the onset of the first cough (103
± 15 seconds). In combination with chlorpheniramine (0.3 mg/kg and 1 mg/kg), the inhibitory
response of theobromine on the citric acid induced tussive activity, was dose dependently
potentiated. Indeed in combination with the highest dose of chlorpheniramine (1 mg/kg)
the total number of coughs was reduced to 10 ± 2 (c.f 15 ± 2 seen in animals treated
with theobromine alone), and onset to the first cough was extended to 130 ± 11 seconds
(c.f. 111 ± 17 seconds).
| Table 6. Cough Suppression of Theobromine and Antihistamine |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
26 ± 4 |
42 ± 9 sec |
| Group 2 |
25 mg/kg codeine (i.p.) |
5 ± 1** |
236 ± 22 sec** |
| Group 3 |
10 mg/kg theobromine (p.o.) |
15 ± 2** |
103 ± 15 sec* |
| Group 4 |
10 mg/kg theobromine (p.o.) 0.3 mg/kg chlorpheniramine (p.o.) |
12 ± 2** |
111 ± 17 sec* |
| Group 5 |
10 mg/kg theobromine (p.o.) 1 mg/kg chlorpheniramine (p.o.) |
10 ± 2** |
130 ± 11 sec** |
| 1 n = 6 guinea pigs per group. |
| ** P < 0.01. |
| * P < 0.05. |
Example 7
Theobromine and an Expectorant
[0138] This example illustrates the antitussive activity of theobromine in combination with
an expectorant.
[0139] Twenty-four male Dunkin Hartley guinea pigs (400-510 g, supplied by Harlan UK Ltd)
were randomly allocated equally into one of four groups. Group 1 animals were administered
vehicle only; Group 2 animals were orally dosed (volume 2 mL/kg) with 10 mg/kg of
theobromine; Group 3 animals were orally dosed (volume 2 mL/kg) with 30 mg/kg guaifenesin;
and Group 4 animals were orally dosed with 10 mg/kg of theobromine and 30 mg/kg guaifenesin.
Pre-treatments with theobromine were administered 30 minutes prior to citric acid
exposure, whereas pre-treatments with guaifenesin or vehicle were administered 60
minutes prior to citric acid exposure. Individual guinea pigs were placed in an exposure
chamber with an airflow of 2 L/min for 10 minutes prior to citric acid exposure to
allow acclimatisation. Cough responses were induced by exposure to 1 M citric acid
aerosol generated by an ultrasonic nebuliser at a nebulisation rate of 0.6 mL/min
for 10 minutes. Coughs were counted throughout the 10 minute citric acid exposure
and for a further 5 minute post-exposure recovery period.
[0140] The results of this study are shown in Table 7. The mean number of citric acid induced
cough responses recorded in the vehicle treated guinea pigs was 30 ± 4 coughs with
a mean onset time for first cough of 46 ± 10 seconds. Pre-treatment with theobromine
(10 mg/kg, p.o.) caused a significant (P<0.05) reduction to the number of citric acid
induced coughs (15 ± 3), as well as an increase duration to the onset of the first
cough (126 ± 12 seconds). In contrast, guaifenesin (30 mg/kg, p.o.) had no significant
effect on the total number of coughs (28 ± 3) evoked by citric acid exposure or on
the onset of the first cough (52 ± 10 seconds). In combination with guaifenesin (30
mg/kg, p.o.), the inhibitory effect of theobromine on the citric acid-induced tussive
activity, showed a trend to be potentiated in respect to total number of coughs observed
(13 ± 3 c.f. 15 ± 3), although such trend was not evident with regard to onset of
the first cough (121 ± 10 seconds c.f. 126 ± 12 seconds).
| Table 7. Cough Suppression of Theobromine and Expectorant |
| Group1 |
Treatment |
Cough Events |
| Mean Number |
Mean Onset Time |
| Group 1 |
vehicle (p.o.) |
30 ± 4 |
46 ± 10 sec |
| Group 2 |
10 mg/kg theobromine (p.o.) |
15 ± 3** |
126 ± 12 sec** |
| Group 3 |
30 mg/kg guaifenesin (p.o.) |
28 ± 3 |
52 ± 10 sec |
| Group 4 |
10 mg/kg theobromine (p.o.) 30 mg/kg guaifenesin (p.o.) |
13 ± 3** |
121 ± 10 sec** |
| 1 n = 6 guinea pigs per group. |
| ** P < 0.01. |
Example 8
Theobromine and a NSAID
[0141] This example illustrates the antitussive activity of theobromine in combination with
a NSAID.
[0142] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) are
randomly allocated equally into one of five groups. Group 1 animals are administered
vehicle only; Group 2 animals are intra-peritoneally dosed (volume 2 mL/kg) with 25
mg/kg of codeine; Group 3 animals are orally dosed (volume 2 mL/kg) with 10 mg/kg
of theobromine; Group 4 animals are orally dosed with 10 mg/kg of theobromine and
10 mg/kg ibuprofen; and Group 5 animals are orally dosed with 10 mg/kg of theobromine
and 30 mg/kg ibuprofen; Group 6 animals are orally doses with 30 mg/kg of ibuprofen
only. Pre-treatments with theobromine are administered 120 minutes prior to citric
acid exposure, whereas pre-treatments with ibuprofen or vehicle are administered 60
minutes prior to citric acid exposure. Pre-treatments with codeine are administered
30 minutes prior to citric acid exposure. Individual guinea pigs are placed in an
exposure chamber with an airflow of 2 L/min for 10 minutes prior to citric acid exposure
to allow acclimatisation. Cough responses are induced by exposure to 1 M citric acid
aerosol generated by an ultrasonic nebuliser at a nebulisation rate of 0.6 mL/min
for 10 minutes. Coughs are counted throughout the 10 minute citric acid exposure and
for a further 5 minute post-exposure recovery period.
[0143] The mean number of citric acid induced cough responses recorded in the vehicle treated
guinea pigs is 30 ± 5 coughs with a mean onset time for first cough of 55 ± 7 seconds.
The level of response is significantly reduced to 8 ± 3 coughs in codeine-treated
animals and the onset to the first cough was significantly extended to 150 ± 32 seconds.
Pre-treatment with theobromine (10 mg/kg) also caused a significant reduction to the
number of citric acid induced coughs (15 ± 3), as well as small increase duration
to the onset of the first cough (113 ± 15 seconds). In combination with both doses
of ibuprofen (10 mg/kg or 30 mg/kg), the inhibitory effect of theobromine on the citric
acid-induced tussive activity was potentiated substantially with both the lower and
higher doses both in respect to the total number of coughs (11 ± 2 c.f. 9 ± 1) and
the onset time to the first cough (143 ± 19 seconds c.f. 122 ± 20 seconds). Ibuprofen
on its own has very little effect on total number of coughs (22 ± 6) or on the onset
time to the first cough (70 ± 5 seconds).
Example 9
Theobromine and an Neuropathic Pain Agent
[0144] This example illustrates the antitussive activity of theobromine in combination with
an neuropathic pain agent.
[0145] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) are
randomly allocated equally into one of five groups. Group 1 animals are administered
vehicle only; Group 2 animals are intra-peritoneally dosed (volume 2 mL/kg) with 25
mg/kg of codeine; Group 3 animals are orally dosed (volume 2 mL/kg) with 10 mg/kg
of theobromine; Group 4 animals are orally dosed with 10 mg/kg of theobromine and
30 mg/kg gabapentin; and Group 5 animals are orally dosed with 10 mg/kg of theobromine
and 60 mg/kg gabapentin; Group 6 animals are orally doses with 60 mg/kg of gabapentin
only. Pre-treatments with theobromine are administered 120 minutes prior to citric
acid exposure, whereas pre-treatments with gabapentin or vehicle are administered
60 minutes prior to citric acid exposure. Pre-treatments with codeine are administered
30 minutes prior to citric acid exposure. Individual guinea pigs are placed in an
exposure chamber with an airflow of 2 L/min for 10 minutes prior to citric acid exposure
to allow acclimatisation. Cough responses are induced by exposure to 1 M citric acid
aerosol generated by an ultrasonic nebuliser at a nebulisation rate of 0.6 mL/min
for 10 minutes. Coughs are counted throughout the 10 minute citric acid exposure and
for a further 5 minute post-exposure recovery period.
[0146] The mean number of citric acid induced cough responses recorded in the vehicle treated
guinea pigs is 31 ± 6 coughs with a mean onset time for first cough of 58 ± 9 seconds.
The level of response is significantly reduced to 9 ± 4 coughs in codeine-treated
animals and the onset to the first cough was significantly extended to 161 ± 31 seconds.
Pre-treatment with theobromine (10 mg/kg) also caused a significant reduction to the
number of citric acid induced coughs (14 ± 4), as well as small increase duration
to the onset of the first cough (108 ± 19 seconds). In combination with gabapentin
(30 mg/kg or 60 mg/kg), the inhibitory effect of theobromine on the citric acid-induced
tussive activity was potentiated significantly with the higher dose both in respect
to the total number of coughs (13 ± 2 c.f. 6 ± 2) and the onset time to the first
cough (89 ± 20 seconds c.f. 142 ± 18 seconds). Gabapentin on its own has very little
effect on total number of coughs (24 ± 8) or on the onset time to the first cough
(90 ± 6 seconds).
Example 10
Theobromine and a Terpene
[0147] This example illustrates the antitussive activity of theobromine in combination with
a terpene.
[0148] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) are
randomly allocated equally into one of five groups. Group 1 animals are administered
vehicle only; Group 2 animals are intra-peritoneally dosed (volume 2 mL/kg) with 25
mg/kg of codeine; Group 3 animals are orally dosed (volume 2 mL/kg) with 10 mg/kg
of theobromine; Group 4 animals are orally dosed with 10 mg/kg of theobromine and
0.3 mg/kg peppermint oil; and Group 5 animals are orally dosed with 10 mg/kg of theobromine
and 1 mg/kg ibuprofen; Group 6 animals are orally doses with 1 mg/kg of peppermint
oil only. Pre-treatments with theobromine and peppermint oil are administered 120
minutes prior to citric acid exposure. Pre-treatments with codeine are administered
30 minutes prior to citric acid exposure. Individual guinea pigs are placed in an
exposure chamber with an airflow of 2 L/min for 10 minutes prior to citric acid exposure
to allow acclimatisation. Cough responses are induced by exposure to 1 M citric acid
aerosol generated by an ultrasonic nebuliser at a nebulisation rate of 0.6 mL/min
for 10 minutes. Coughs are counted throughout the 10 minute citric acid exposure and
for a further 5 minute post-exposure recovery period.
[0149] The mean number of citric acid induced cough responses recorded in the vehicle treated
guinea pigs is 27 ± 5 coughs with a mean onset time for first cough of 62 ± 7 seconds.
The level of response is significantly reduced to 6 ± 2 coughs in codeine-treated
animals and the onset to the first cough was significantly extended to 170 ± 28 seconds.
Pre-treatment with theobromine (10 mg/kg) also caused a significant reduction to the
number of citric acid induced coughs (14 ± 5), as well as small increase duration
to the onset of the first cough (120 ± 23 seconds). In combination with peppermint
oil (0.3 mg/kg or 1 mg/kg), the inhibitory effect of theobromine on the citric acid-induced
tussive activity was potentiated substantially only with the higher dose both in respect
to the total number of coughs (15 ± 3 c.f. 6 ± 2) and the onset time to the first
cough (115 ± 17 seconds c.f. 130 ± 25 seconds). Peppermint oil on its own has no effect
on total number of coughs (26 ± 10) or on the onset time to the first cough (75 ±
8 seconds).
Example 11
Theobromine and an ACE Inhibitor
[0150] This example illustrates the antitussive activity of theobromine in combination with
an ACE inhibitor.
[0151] Thirty male Dunkin Hartley guinea pigs (400-500 g, supplied by Harlan UK Ltd) are
randomly allocated equally into one of five groups. Group 1 animals are administered
vehicle only; Group 2 animals are intra-peritoneally dosed (volume 2 mL/kg) with 25
mg/kg of codeine; Group 3 animals are orally dosed (volume 2 mL/kg) with 30 mg/kg
of theobromine; Group 4 animals are orally dosed with 30 mg/kg of captopril; and Group
5 animals are orally dosed with 30 mg/kg of theobromine and 30 mg/kg captopril. Pre-treatments
with theobromine and captopril are administered 120 minutes prior to citric acid exposure.
Pre-treatments with codeine are administered 30 minutes prior to citric acid exposure.
Individual guinea pigs are placed in an exposure chamber with an airflow of 2 L/min
for 10 minutes prior to citric acid exposure to allow acclimatisation. Cough responses
are induced by exposure to 1 M citric acid aerosol generated by an ultrasonic nebuliser
at a nebulisation rate of 0.6 mL/min for 10 minutes. Coughs are counted throughout
the 10 minute citric acid exposure and for a further 5 minute post-exposure recovery
period.
[0152] The mean number of citric acid induced cough responses recorded in the vehicle treated
guinea pigs is 29 ± 9 coughs with a mean onset time for first cough of 66 ± 8 seconds.
The level of response is significantly reduced to 7 ± 3 coughs in codeine-treated
animals and the onset to the first cough was significantly extended to 170 ± 28 seconds.
Pre-treatment with theobromine (30 mg/kg) also caused a significant reduction to the
number of citric acid induced coughs (10 ± 4), as well as small increase duration
to the onset of the first cough (125 ± 22 seconds). Pretreatment with captopril (30
mg/kg), substantially increased the protussive effect of citric acid, with total number
of coughs (45 ± 12) and the shortened the onset time to the first cough (34 ± 12 seconds).
Combining the captopril and theobromine reduced the total number of coughs compared
to the captopril alone group (18 ± 10) and lengthened the onset time to the first
cough (70 ± 12 seconds).
Example 12
Treatment of a Coughing Condition
[0153] A 26 year old woman complains of coughing all the time. After routine history and
physical examination, a physician diagnosis the woman with a coughing condition associated
with smoking. The woman is treated by inhalatory administration a pharmaceutical composition
comprising theobromine and dextromethophan as disclosed herein taken four times daily.
Alternatively, the woman may be treated by oral administration a pharmaceutical composition
comprising theobromine and dextromethophan as disclosed herein taken twice times daily.
The patient's condition is monitored and after about 2 days from treatment, the woman
indicates she is experiencing decreased coughing episodes. At two and four month check-ups,
the woman indicates that she is still taking the medication and is still experiencing
decreased episodes of coughing. This decrease in coughing episodes indicates successful
treatment with the pharmaceutical composition disclosed herein.
[0154] In a similar manner, a pharmaceutical composition comprising theobromine and any
of the therapeutic compounds disclosed herein, such as,
e.g., a non-opiate antitussive, an opiate antitussive, a decongestant, an expectorant,
a mucolytic agent, an anti-histamine, a NSAID, a neuropathic pain agent, a terpene,
or any combination thereof, will be formulated into a pharmaceutical composition and
administered to the patient as described above.
[0155] A 78 year old man complains of coughing all the time. After routine history and physical
examination, a physician diagnosis the man with a coughing condition associated with
tuberculosis. The man is treated by inhalatory administration a pharmaceutical composition
comprising theobromine and codeine as disclosed herein taken four times daily. Alternatively,
the man may be treated by oral administration a pharmaceutical composition comprising
theobromine and codeine as disclosed herein taken twice times daily. The patient's
condition is monitored and after about 2 days from treatment, the man indicates he
is experiencing decreased coughing episodes. At two and four month check-ups, the
man indicates that he is still taking the medication and is still experiencing decreased
episodes of coughing. This decrease in coughing episodes indicates successful treatment
with the pharmaceutical composition disclosed herein.
[0156] In a similar manner, a pharmaceutical composition comprising theobromine and any
of the therapeutic compounds disclosed herein, such as,
e.g., a non-opiate antitussive, an opiate antitussive, a decongestant, an expectorant,
a mucolytic agent, an anti-histamine, a NSAID, a neuropathic pain agent, a terpene,
or any combination thereof, will be formulated into a pharmaceutical composition and
administered to the patient as described above.
[0157] A 58 year old male complains of coughing due to breathing difficulty. After routine
history and physical examination, a physician diagnosis the man with a coughing condition
associated with a chronic obstructive pulmonary disease (COPD). The man is treated
by inhalatory administration a pharmaceutical composition comprising theobromine and
pseudoephidrine as disclosed herein taken four times daily. Alternatively, the man
may be treated by oral administration a pharmaceutical composition comprising theobromine
and pseudoephidrine as disclosed herein taken twice times daily. The patient's condition
is monitored and after about 2 days from treatment, the man indicates he is experiencing
decreased coughing episodes. At two and four month check-ups, the man indicates that
he is still taking the medication and is still experiencing decreased episodes of
coughing. This decrease in coughing episodes indicates successful treatment with the
pharmaceutical composition disclosed herein.
[0158] In a similar manner, a pharmaceutical composition comprising theobromine and any
of the therapeutic compounds disclosed herein, such as,
e.g., a non-opiate antitussive, an opiate antitussive, a decongestant, an expectorant,
a mucolytic agent, an anti-histamine, a NSAID, a neuropathic pain agent, a terpene,
or any combination thereof, will be formulated into a pharmaceutical composition and
administered to the patient as described above.
[0159] A 18 year old woman complains of coughing and stuffed-up nose. After routine history
and physical examination, a physician diagnosis the woman with a coughing condition
associated with a respiratory tract infection. The woman is treated by inhalatory
administration a pharmaceutical composition comprising theobromine and ibuprofen as
disclosed herein taken four times daily. Alternatively, the woman may be treated by
oral administration a pharmaceutical composition comprising theobromine and ibuprofen
as disclosed herein taken twice times daily. The patient's condition is monitored
and after about 2 days from treatment, the woman indicates she is experiencing decreased
coughing episodes. At one and two week check-ups, the woman indicates that she is
not coughing and feels great. This decrease in coughing episodes indicates successful
treatment with the pharmaceutical composition disclosed herein.
[0160] In a similar manner, a pharmaceutical composition comprising theobromine and any
of the therapeutic compounds disclosed herein, such as,
e.g., a non-opiate antitussive, an opiate antitussive, a decongestant, an expectorant,
a mucolytic agent, an anti-histamine, a NSAID, a neuropathic pain agent, a terpene,
or any combination thereof, will be formulated into a pharmaceutical composition and
administered to the patient as described above.
[0161] A 47 year old woman complains of coughing and runny nose. After routine history and
physical examination, a physician diagnosis the woman with a coughing condition associated
with an allergy. The woman is treated by inhalatory administration a pharmaceutical
composition comprising theobromine and chlorpheniramine as disclosed herein taken
four times daily. Alternatively, the woman may be treated by oral administration a
pharmaceutical composition comprising theobromine and chlorpheniramine as disclosed
herein taken twice times daily. The patient's condition is monitored and after about
2 days from treatment, the woman indicates she is experiencing decreased coughing
episodes. At one and two month check-ups, the woman indicates that she is not coughing
and does not have a runny nose. This decrease in coughing episodes indicates successful
treatment with the pharmaceutical composition disclosed herein.
[0162] In a similar manner, a pharmaceutical composition comprising theobromine and any
of the therapeutic compounds disclosed herein, such as,
e.g., a non-opiate antitussive, an opiate antitussive, a decongestant, an expectorant,
a mucolytic agent, an anti-histamine, a NSAID, a neuropathic pain agent, a terpene,
or any combination thereof, will be formulated into a pharmaceutical composition and
administered to the patient as described above.
[0163] A 34 year old male complains of coughing due to breathing difficulty. After routine
history and physical examination, a physician diagnosis the man with a coughing condition
associated with a chest cold. The man is treated by inhalatory administration a pharmaceutical
composition comprising theobromine and guaifenesin as disclosed herein taken four
times daily. Alternatively, the man may be treated by oral administration a pharmaceutical
composition comprising theobromine and guaifenesin as disclosed herein taken twice
times daily. The patient's condition is monitored and after about 2 days from treatment,
the man indicates he is experiencing decreased coughing episodes. At one and two week
check-ups, the man indicates that indicates that his chest is cleared and his is not
coughing. This decrease in coughing episodes indicates successful treatment with the
pharmaceutical composition disclosed herein.
[0164] In a similar manner, a pharmaceutical composition comprising theobromine and any
of the therapeutic compounds disclosed herein, such as,
e.g., a non-opiate antitussive, an opiate antitussive, a decongestant, an expectorant,
a mucolytic agent, an anti-histamine, a NSAID, a neuropathic pain agent, a terpene,
or any combination thereof, will be formulated into a pharmaceutical composition and
administered to the patient as described above.
[0165] A 67 year old male complains of coughing due to a medication including an ACE inhibitor
for hypertension. After routine history and physical examination, a physician diagnosis
the man with a coughing condition that is a side-effect of his ACE inhibitor medication.
The man is treated by inhalatory administration a pharmaceutical composition comprising
theobromine as disclosed herein in conjunction with his ACE inhibitor medication.
Alternatively, the man may be treated by oral administration a pharmaceutical composition
comprising theobromine as disclosed herein in conjunction with his ACE inhibitor medication.
Alternatively, the man may be treated by inhalatory administration a pharmaceutical
composition comprising theobromine and the ACE inhibitor as disclosed herein taken
four times daily. Alternatively, the man may be treated by oral administration a pharmaceutical
composition comprising theobromine and the ACE inhibitor as disclosed herein taken
twice times daily. The patient's condition is monitored and after about 2 days from
treatment, the man indicates he is experiencing decreased coughing episodes. At two
and four month check-ups, the man indicates that he is still taking the medication
and is still experiencing decreased episodes of coughing. This decrease in coughing
episodes indicates successful treatment with the pharmaceutical composition disclosed
herein.
[0166] A 73 year old male complains of coughing due to a medication including an angiotensin
II receptor antagonist for hypertension. After routine history and physical examination,
a physician diagnosis the man with a coughing condition that is a side-effect of his
ACE inhibitor medication. The man is treated by inhalatory administration a pharmaceutical
composition comprising theobromine as disclosed herein in conjunction with his angiotensin
II receptor antagonist medication. Alternatively, the man may be treated by oral administration
a pharmaceutical composition comprising theobromine as disclosed herein in conjunction
with his angiotensin II receptor antagonist medication. Alternatively, the man may
be treated by inhalatory administration a pharmaceutical composition comprising theobromine
and the angiotensin II receptor antagonist as disclosed herein taken four times daily.
Alternatively, the man may be treated by oral administration a pharmaceutical composition
comprising theobromine and the angiotensin II receptor antagonist as disclosed herein
taken twice times daily. The patient's condition is monitored and after about 2 days
from treatment, the man indicates he is experiencing decreased coughing episodes.
At two and four month check-ups, the man indicates that he is still taking the medication
and is still experiencing decreased episodes of coughing. This decrease in coughing
episodes indicates successful treatment with the pharmaceutical composition disclosed
herein.
[0167] In closing, it is to be understood that although aspects of the present specification
are highlighted by referring to specific embodiments, one skilled in the art will
readily appreciate that these disclosed embodiments are only illustrative of the principles
of the subject matter disclosed herein. Therefore, it should be understood that the
disclosed subject matter is in no way limited to a particular methodology, protocol,
and/or reagent, etc., described herein. As such, various modifications or changes
to or alternative configurations of the disclosed subject matter can be made in accordance
with the teachings herein without departing from the spirit of the present specification.
Lastly, the terminology used herein is for the purpose of describing particular embodiments
only, and is not intended to limit the scope of the present invention, which is defined
solely by the claims. Accordingly, the present invention is not limited to that precisely
as shown and described.
[0168] Certain embodiments of the present invention are described herein, including the
best mode known to the inventors for carrying out the invention. Of course, variations
on these described embodiments will become apparent to those of ordinary skill in
the art upon reading the foregoing description. The inventor expects skilled artisans
to employ such variations as appropriate, and the inventors intend for the present
invention to be practiced otherwise than specifically described herein. Accordingly,
this invention includes all modifications and equivalents of the subject matter recited
in the claims appended hereto as permitted by applicable law. Moreover, any combination
of the above-described embodiments in all possible variations thereof is encompassed
by the invention unless otherwise indicated herein or otherwise clearly contradicted
by context.
[0169] Groupings of alternative embodiments, elements, or steps of the present invention
are not to be construed as limitations. Each group member may be referred to and claimed
individually or in any combination with other group members disclosed herein. It is
anticipated that one or more members of a group may be included in, or deleted from,
a group for reasons of convenience and/or patentability. When any such inclusion or
deletion occurs, the specification is deemed to contain the group as modified thus
fulfilling the written description of all Markush groups used in the appended claims.
[0170] Unless otherwise indicated, all numbers expressing a characteristic, item, quantity,
parameter, property, term, and so forth used in the present specification and claims
are to be understood as being modified in all instances by the term "about." As used
herein, the term "about" means that the characteristic, item, quantity, parameter,
property, or term so qualified encompasses a range of plus or minus ten percent above
and below the value of the stated characteristic, item, quantity, parameter, property,
or term. Accordingly, unless indicated to the contrary, the numerical parameters set
forth in the specification and attached claims are approximations that may vary. At
the very least, and not as an attempt to limit the application of the doctrine of
equivalents to the scope of the claims, each numerical indication should at least
be construed in light of the number of reported significant digits and by applying
ordinary rounding techniques. Notwithstanding that the numerical ranges and values
setting forth the broad scope of the invention are approximations, the numerical ranges
and values set forth in the specific examples are reported as precisely as possible.
Any numerical range or value, however, inherently contains certain errors necessarily
resulting from the standard deviation found in their respective testing measurements.
Recitation of numerical ranges of values herein is merely intended to serve as a shorthand
method of referring individually to each separate numerical value falling within the
range. Unless otherwise indicated herein, each individual value of a numerical range
is incorporated into the present specification as if it were individually recited
herein.
[0171] The terms "a," "an," "the" and similar referents used in the context of describing
the present invention (especially in the context of the following claims) are to be
construed to cover both the singular and the plural, unless otherwise indicated herein
or clearly contradicted by context. All methods described herein can be performed
in any suitable order unless otherwise indicated herein or otherwise clearly contradicted
by context. The use of any and all examples, or exemplary language (e.g., "such as")
provided herein is intended merely to better illuminate the present invention and
does not pose a limitation on the scope of the invention otherwise claimed. No language
in the present specification should be construed as indicating any non-claimed element
essential to the practice of the invention.
[0172] Specific embodiments disclosed herein may be further limited in the claims using
consisting of or consisting essentially of language. When used in the claims, whether
as filed or added per amendment, the transition term "consisting of" excludes any
element, step, or ingredient not specified in the claims. The transition term "consisting
essentially of" limits the scope of a claim to the specified materials or steps and
those that do not materially affect the basic and novel characteristic(s). Embodiments
of the present invention so claimed are inherently or expressly described and enabled
herein.
[0173] All patents, patent publications, and other publications referenced and identified
in the present specification are individually and expressly incorporated herein by
reference in their entirety for the purpose of describing and disclosing, for example,
the compositions and methodologies described in such publications that might be used
in connection with the present invention. These publications are provided solely for
their disclosure prior to the filing date of the present application. Nothing in this
regard should be construed as an admission that the inventors are not entitled to
antedate such disclosure by virtue of prior invention or for any other reason. All
statements as to the date or representation as to the contents of these documents
is based on the information available to the applicants and does not constitute any
admission as to the correctness of the dates or contents of these documents.